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This morning, Senate Republicans released their proposal to repeal and replace the Affordable Care Act (ACA). Called the Better Care Reconciliation Act of 2017 (BCRA), the Senate proposal adopts H.R. 1628, the bill narrowly passed last month by the House of Representatives, but replaces all the text. The Senate proposal was released without going through committee review or being scored by the Congressional Budget Office (CBO). Next week, after the CBO provides cost and impact estimates, the full Senate will begin debating and amending the proposed legislation.

As was the case with the House bill, the Senate’s BCRA primarily focuses on funding for Medicaid and other state programs, maintaining stability in the individual insurance markets, and giving individual states more flexibility in opting out of insurance reforms. Also included are a number of provisions offering relief to employers and reducing the scope of requirements on group health plans. Below are highlights of provisions of the most interest to employers.

Employer Highlights:

  • Employer Mandate: The BCRA would repeal the ACA’s employer shared responsibility provision, that is the so-called “employer mandate” or “play or pay,” as of 2016. The rules for 2015 would not change, which would still be an issue for certain large employers that did not qualify for transition relief that year.
  • Employer Reporting: The existing rules requiring completion of Forms 1094 and 1095 would continue to apply, although the IRS may have the ability to soften them in the future.
  • Taxes and Fees: The Cadillac tax on high-cost health plans would be delayed six years, then take effect in 2026. The PCORI fee would continue as previously scheduled for plan years through September 2019. The additional Medicare tax on high earners would be repealed starting in 2023.
  • Health Plan Requirements: Current ACA rules regarding eligibility for children to age 26, limits on waiting periods, prohibitions against annual or lifetime dollar limits, and most other provisions would continue unchanged. Coverage for pre-existing conditions generally would be protected, at least for persons that maintained continuous coverage.
  • Essential Health Benefits (EHBs): The ACA currently requires broad coverage of all EHBs in the small group insurance market (unless grandfathered or grandmothered). The BCRA would give the individual states broad flexibility to determine EHBs and to change or reduce any coverage standards.
  • Health Savings Accounts (HSAs): The annual HSA contribution limits would be increased significantly for years after 2017.
  • Health Flexible Spending Accounts (HFSAs): The annual contribution limit, currently $2,600 per 12-month period, would be repealed for years after 2017.
  • Over-the-counter (OTC) medications: The ACA prohibits HSAs, HFSAs, and other reimbursement accounts from covering OTC medications (unless prescribed or insulin). The BCRA would repeal this provision for years after 2017.

Summary

The Senate proposal is similar to the House bill in most areas that directly affect employers, such as relief from the employer mandate, repeal of various health plan fees and taxes, and fewer restrictions on group insurance and benefit plan designs. Those sections, however, are part of a large piece of legislation that may face obstacles in the Senate due to the proposal’s significant impact on Medicaid funding and the individual insurance markets. Without support from at least 50 of the 52 Senate Republicans, the legislation will fail. At this time, at least four of those Senators are withholding their support.

Originally Posted By www.thinkhr.com

AHCA and the Preexisting Conditions Debate—What Employers Can Do During Uncertainty | Ohio Benefit Advisors

Categories: Benefits, Blog, Employers, Preexisting Conditions, Team K Blog
Comments Off on AHCA and the Preexisting Conditions Debate—What Employers Can Do During Uncertainty | Ohio Benefit Advisors

Preexisting conditions. While it’s no doubt this term has been a hot topic in recent months—and notably misconstrued—one thing has not changed; insurers cannot deny coverage to anyone with a preexisting condition.  Now that House Resolution 1628 has moved to the Senate floor, what can employers and individuals alike expect? If passed by the Senate as is and signed into law; some provisions will take place as early as 2019—possibly 2018 for special enrollment cases. It’s instrumental for companies to gear up now with a plan on how to tackle open enrollment; regardless of whether your company offers medical coverage or not.

Under the current proposed American Health Care Act (AHCA) insurance companies can:

  • Price premiums based on health care status/age. The AHCA will provide “continuous coverage” protections to guarantee those insured are not charged more than the standard rate as long as they do not have a break in coverage. However, insurers will be allowed to underwrite certain policies for those that do lapse—hence charging up to 30% more for a preexisting condition if coverage lapses for more than 63 days. This is more common than not, especially for those who are on a leave of absence for illness or need extensive treatment. In addition, under current law, insurers are only allowed to charge individuals 50 and older 3 times as much than those under this age threshold. This ratio will increase 5:1 under AHCA.
  • Under the ACA’s current law employers must provide coverage for 10 essential health care benefits. Under AHCA, beginning as early as 2020, insurers will allow states to mandate what they consider essential benefit requirements. This could limit coverage offered to individuals and within group plans by eliminating high cost care like mental health and substance abuse. Not that it’s likely, but large employers could eventually opt out whether they want to provide insurance and/or choose the types of coverage they will provide to their employees.

It’s important to note that states must apply for waivers to increase the ratio on insurance premiums due to age, and determine what they will cover for essential health benefits. In order to have these waivers granted, they would need to provide extensive details on how doing so will help their state and the marketplace.

So what can employers do moving forward? It’s not too soon to think about changing up your benefits package as open enrollment approaches, and educating yourself and your staff on AHCA and what resources are out there if you don’t offer health coverage.

  • Make a variety of supplemental tools available to your employees. Anticipate the coming changes by offering or adding more supplemental insurance and tools to your benefits package come open enrollment. Voluntary worksite benefits, such as Cancer, Critical Illness, and Accident Insurance handle a variety of services at no out-of-pocket cost to the employer. HSA’s FSA’s and HRA’s are also valuable supplemental tools to provide your employees if you’re able to do so. Along with the changes listed above, the AHCA has proposed to also increase the contribution amounts in these plans and will allow these plans to cover Over-the-Counter (OTC) medications.
  • Continue to customize wellness programs. Most companies offer wellness programs for their employees. Employers that provide this option should continue advancing in this area. Addressing the specific needs of your employees and providing wellness through various platforms will result in the greatest return on investment; and healthier employees to boot. Couple this with frequent evaluations from your staff on your current program to determine effectiveness and keep your wellness programs on point.
  • Educate, educate, educate—through technology. Regardless if you employ 10 or 10,000, understanding benefit options is vital for your employees; what you have to offer them and what they may need to know on their own. Digital platforms allow individuals to manage their healthcare benefits and stay in the know with valuable resources at their fingertips. There’s no limit on the mediums available to educate your employees on upcoming changes. Partnering with a strong benefit agency to maximize these resources and keep your employees “in the know” during a constantly changing insurance market is a great way to start.

This month we’re highlighting Account Manager and Wellness Coordinator, Jenny Howe!  We’ve asked Jenny a few fun questions to get to know her a little bit better!

How long have you been with the company?  11 years on 4/26/17

What is the favorite aspect of your job?   Interacting with the employers and employee’s.

Do you have a favorite sports team? Not really, if I had to choose something it would be Ohio State Buckeye’s.

Where is the furthest you have traveled? I have only traveled in the states.  I guess the furthest would be San Diego, California.

Do you volunteer? I spend a great deal of time helping at my kids school, St. Patrick of Heatherdowns.  I coach Cross Country and Track and I am on the Student Advisory Committee.

Do you have any collections or hobbies?  I enjoy running.  I just completed my 8th Half Marathon and have also completed 2 25K’s (15 ½ miles).

How many states have you lived in or have you lived in another country?  I have lived in Ohio and Florida.

Before working at Kaminsky & Associates, what was the most unusual or interesting job you’ve ever had?  I was a bartender for almost 10 years.

Motto or personal mantra?  You only live once, make it a good one.

What did you want to be when growing up?  A Teacher.

What is your favorite movie and book?  I really enjoy James Patterson books.

Any favorite line from a movie?  You can’t handle the truth! (A Few Good Men)

The change in the regulations that would increase the salary threshold for overtime exemption that was all over the news for the last several months may now be decided by the end of June.

The Fifth Circuit Court of Appeals has granted the U.S. Department of Labor (DOL) another 60-day extension of time to file its final reply brief in the in the pending appeal of a nationwide injunction issued by a federal district court in Texas blocking implementation of the DOL’s final overtime rule. As we reported at the time, the final rule, which raised the salary threshold for the white collar overtime exemptions, was scheduled to go into effect on December 1, 2016. The final brief is now required to be filed by June 30, 2017. In its unopposed motion, the DOL stated that the extension was necessary “to allow incoming leadership personnel adequate time to consider the issues” and noted that the nominee for Secretary of Labor has not been confirmed.

As a result of the extension, it is not likely that employers will see any resolution of this issue until midsummer at the earliest. This also assumes that President Trump’s nominee for Secretary of Labor, Alexander Acosta, is confirmed within the next few weeks.

By Rick Montgomery, JD
Originally published by www.thinkhr.com

One might describe the series of events leading to the death of the American Health Care Act (Congress’s bill to repeal and replace the Affordable Care Act) as something like a ballistic missile exploding at launch. The Patient Protection and Affordable Care Act (ACA) repeal debate began nearly a decade ago with former President Barack Obama’s first day in office and reemerged as a serious topic during the 2016 presidential election. Even following the retraction of the House bill, repeal of the ACA remains a possibility as the politicians consider alternatives to the recent bill. The possibility of pending legislation has caused some clients to question the need to complete their obligation for ACA reporting on a timely basis this year. The legislative process has produced a great deal of uncertainty which is one thing employers do not like, especially during the busy year end.

While the “repeal and replace” activity is continuing, it is imperative that employers and their brokers put their noses to the grindstone to fulfill all required reporting requirements. To accomplish this, employers will need brokers that can effectively guide them through this tumultuous season. We recommend that employers ask their brokers about their strategies for

  • Implementing the employer shared responsibility reporting
  • Sending all necessary forms to the employer’s employees
  • Submitting the employer’s reporting to the IRS
  • Closing out the employer’s 2016 filing season

Employers should also inquire about any additional support that the broker provides. They should provide many of the services that we at Health Cost Manager provide to our clients: They should apprise their clients of the latest legislative updates through regular email communication and informational webinars. Brokers should also bring in experts in the field that have interacted with key stakeholders in Washington. And most important, they should remain available during this uncertain period to answer any questions or concerns from clients.

We know employers would prefer not to have to comply with these reporting obligations – many have directly told us so. We understand this requires additional work on their part to gather information for the reporting and increased compliance responsibility. Knowing how stressful the reporting season can be for employers, brokers should go out of their way to help their clients feel confident that they can steer through the reporting process smoothly. The broker’s role should be to take as much of the burden off the employer’s shoulders as possible to enable them to reach compliance in the most expedient manner possible. Sometimes this involves stepping in to solve data or other technical issues, or answering a compliance-related question that helps the client make important decisions. It’s all part of helping employers navigate through the ACA’s strong headwinds during these uncertain times.

Audit-proof your company with UBA’s latest white paper: Don’t Roll the Dice on Department of Labor Audits. This free resource offers valuable information about how to prepare for an audit, the best way to acclimate staff to the audit process, and the most important elements of complying with requests.

The IRS updated its longstanding Q&A guidance on codes that employers should use when completing Forms 1094-C and 1095-C. For information on the IRS’ updated guidance, including COBRA reporting information that had been left pending in earlier versions of the IRS guidance for the past year, view UBA’s ACA Advisor, “IRS Q&A About Employer Information Reporting on Form 1094-C and Form 1095-C”.

By Michael Weiskirch
www.ubabenefits.com

Flex Work.  No doubt you’ve heard this term (or some variation) floating around the last decade or so, but what exactly does it mean? Flexible work can vary by definition depending on who you ask, but one thing is for sure, it’s here to stay and changing the way we view the workforce. According to a recent study by Randstad, employer commitment to increase the amount of flex workers in their companies has increased 155% over the last four years. If fact, 68% of employers agree that the majority of the workforce will be working some sort of flexible arrangement by 2025.

So then, since the landscape of a traditional office setting is changing, what exactly is Flex Work? Simply stated, it’s a practice employers use to allow their staff some discretion and freedom in how to handle their work, while making sure their schedules coordinate with colleagues. Parameters are set by the employer on how to get the work accomplished.  These guidelines may include employees working a set number of hours per day/week, and specifying core times when they need to be onsite. No matter how it’s defined, with a new generation entering the workforce and technology continuing to advance, employers will need to explore this trend to stay competitive.

Let’s take a look at how this two-fold benefit has several advantages for employers and employees alike.

Increases Productivity

When employees work a more flexible schedule, they are more productive. Many will get more done in less time, have less distractions, take less breaks, and use less sick time/PTO than office counterparts. In several recent studies, employees have stated they’re more productive when not in a traditional office setting. In a recent article published by Entrepreneur.com, Sara Sutton, CEO and Founder of FlexJobs wrote that 54% of 1500 employees polled in one of their surveys would choose to undertake important job-related assignments from home rather than the office. And 18% said that while they would prefer to complete assignments at the office, they would only do so before or after regular hours. A mere 19% said they’d go to the office during regular hours to get important assignments done.

Flexible workplaces allow employees to have less interruptions from impromptu meetings and colleagues, while minimizing the stress of office chatter and politics—all of which can drain productivity both at work and at home. What’s more, an agile setting allows your employees to work when their energy level is at peak and their focus is best. So, an early-riser might benefit from working between the hours of 4:30 and 10 a.m., while other staff members excel in the evening; once children are in bed.

Reduces Cost Across the Board

Think about it, everything we do costs us something. Whether we’re sacrificing time, money, or health due to stress, cost matters. With a flexible work environment, employees can tailor their hours around family needs, personal obligations and life responsibilities without taking valuable time away from their work. They’re able to tap into work remotely while at the doctor, caring for a sick child, waiting on the repairman, or any other number of issues.

What about the cost associated with commuting? Besides the obvious of fuel and wear and tear on a vehicle, an average worker commutes between 1-2 hours a day to the office. Tack on the stress involved in that commute and an 8 hour workday, and you’ve got one tired, stressed out employee with no balance. Telecommuting reduces these stressors, while adding value to the company by eliminating wasted time in traffic. And, less stress has a direct effect – healthier and happier employees.

Providing a flexible practice in a traditional office environment can reduce overhead costs as well. When employees are working remotely, business owners can save by allowing employees to desk or space share. Too, an agile environment makes it easier for businesses to move away from traditional brick and mortar if they deem necessary.

Boosts Loyalty, Talent and the Bottom Line

We all know employees are the number one asset in any company. When employees have more control over their schedule during the business day, it breeds trust and reduces stress. In fact, in a recent survey of 1300 employees polled by FlexJobs, 83% responded they would be more loyal to their company if they offered this benefit. Having a more agile work schedule not only reduces stress, but helps your employees maintain a good work/life balance.

Offering this incentive to prospective and existing employees also allows you to acquire top talent because you aren’t limited by geography. Your talent can work from anywhere, at any time of the day, reducing operational costs and boosting that bottom line—a very valuable asset to any small business owner or new start-up.

So, what can employers do?  While there are still companies who view flexible work as a perk rather than the norm, forward-thinking business owners know how this will affect them in the next few years as they recruit and retain new talent. With 39% of permanent employees thinking to make the move to an agile environment over the next three years, it’s important to consider what a flexible environment could mean for your company.  Keep in mind there are many types that can be molded to fit your company’s and employees’ needs. Flexible work practices don’t have to be a one-size-fits-all approach. As the oldest of Generation Z is entering the workforce, and millennials are settling into their careers, companies are wise to figure out their own customized policies. The desire for a more flexible schedule is key for the changing workforce—often times over healthcare, pay and other benefits. Providing a flexible arrangement will keep your company competitive.

Many employers understand the value of having an Employee Assistance Program (EAP) since the heart and soul of organizations are employees. Employees who are physically and mentally healthy, highly productive, engaged in their work, and loyal to their employer contribute positively to their employer’s bottom line. Fortunately, most employees are positive contributors, yet even the best of employees can occasionally have issues or circumstances arise that may inadvertently impact their jobs in a negative way. Having an EAP in place that can address these issues early may mitigate any negative impact to the workplace. This is a win-win for both employees and employers.

A key component of EAP services lies in “catching things early” by assisting employees and helping them address and resolve issues before they impact the workplace. Most employees will use EAP services on a voluntary, self-referred basis that is completely confidential. Some employers may wonder if services are even being used by employees because it won’t be all that apparent, but most EAPs provide a utilization or usage report that will show the number of people served, and possibly the types of reasons services were requested.

If employee issues do begin to appear in the workplace—related to performance, attendance, behavior, or safety—it is important for managers, supervisors, and human resources to also have access to EAP services. They may wish to consult with an employee assistance professional that can provide guidance and direction leading to problem identification and resolution. These issues have the potential to become very costly for the organization—and again, the earlier they can be addressed, the greater chance of success for both employee and employer, with minimal negative impact to the company’s bottom line.

The key to getting the most out of an EAP is to make it easily accessible to employees, safe to use, and visible enough they remember to use it. It is important that employees understand using the EAP is confidential and their identity will not be disclosed to anyone in their organization. Promoting the EAP services with materials such as flyers, posters, or website information with EAP contact information will also increase the likelihood of employees accessing services.

By Nancy Cannon
Originally published by www.ubabenefits.com

On April 4, 2017, the Department of Labor (DOL) announced that the applicability date for the final fiduciary rule will be extended, and published its final rule extending the applicability date in the Federal Register on April 7. This extension is pursuant to President Trump’s February 3, 2017 presidential memorandum directing the DOL to further examine the rule and the DOL’s proposed rule to extend the deadline released on March 2, 2017.

The length of the extension differs between certain requirements and/or components of the rule.  Below are the components and when and how applicability applies:

  • Final rule defining who is a “fiduciary”: Under the final rule, advisors who are compensated for providing investment advice to retirement plan participants and individual account owners, including plan sponsors, are fiduciaries. The applicability date for the final rule is extended 60 days, from April 10 until June 9, 2017. Fiduciaries will be required to comply with the impartial conduct or “best interest” standards on the June 9 applicability date.
  • Best Interest Contract Exemption: Except for the impartial conduct standards (applicable June 9 per above), all other conditions of this exemption for covered transactions are applicable January 1, 2018. Therefore, fiduciaries intending to use this exemption must comply with the impartial conduct standard between June 9, 2017 and January 1, 2018.
  • Class Exemption for Principal Transactions: Except for the impartial conduct standards (applicable June 9 per above), all other conditions of this exemption for covered transactions are applicable January 1, 2018. Therefore, fiduciaries intending to use this exemption must comply with the impartial conduct standard between June 9, 2017 and January 1, 2018 and thereafter.
  • Prohibited Transaction Exemption 84-24 (relating to annuities): Except for the impartial conduct standard (applicable June 9 per above), the amendments to this exemption are applicable January 1, 2018.
  • Other previously granted exemptions: All amendments to other previously granted exemptions are applicable on June 9, 2017.

By Nicole Quinn-Gato, JD
Originally published by www.thinkhr.com

Customization of benefits is becoming more popular.  The process of personalizing employee benefits allows for individuals to choose from an array of options, and increases employee satisfaction.

 

 

 

On Friday, Republicans in the U.S. House of Representatives pulled pending legislation, known as the American Health Care Act, from further consideration. The bill had been scheduled for a vote on the House floor Friday afternoon but, recognizing that it was headed for defeat, the House leadership cancelled the vote.

It is now unlikely that Congress will pursue any legislation to repeal or replace the Affordable Care Act (ACA) this year. That does not mean, however, that we will not see changes in how the ACA is enforced. President Trump has directed the Departments of Labor (DOL), Treasury (including the IRS), and Health and Human Services (HHS) to review all existing regulations and to initiate steps to revise or eliminate burdensome rules. Congress also may use authority under the Congressional Review Act (CRA) to overturn, with a simple majority, certain regulations if they had been finalized only recently.

As the focus moves from the legislative to the regulatory arena, ThinkHR will continue to monitor and report on ACA developments that impact employers and their group health plans.

By Laura Kerekes
Originally published by www.thinkhr.com