White House To Delay Employer Mandate Until 2015

Originally published by Avik Roy on https://www.forbes.com

The Obama administration has decided to delay the implementation of the employer mandate—the requirement that all firms with 50 or more employees offer health coverage, or pay steep fines—until 2015. The mandate was supposed to go into effect on January 1, 2014. This development will have a significant impact on the rollout of the PPACA, the private health insurance market, and the nation’s economy, as I detail below.

The news was first reported by Mike Dorning and Alex Wayne of Bloomberg this afternoon. The ruling, they say, “will come in regulatory guidance to be issued later this week. It addresses vehement complaints from employer groups about the administrative burden of reporting requirements, though it may also affect coverage provided to some workers.”

“First,” wrote Treasury official Mark Mazur in a statement, the delay “will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.” (Mazur’s full statement is appended to the end of this article.)

Will more employers dump coverage if the mandate is delayed?

As a matter of background, Section 1513/4890H of the Affordable Care Act requires that all firms with more than 50 full-time-equivalent employees—defined as 120 hours per month—offer government-certified health coverage to their workers, or pay a steep fine. For more details on how the mandate works, and how it incentivizes firms to offer “unaffordable” coverage to their workers, read mypiece on the topic from May 21.

In the short term, the delay will have several effects. First, the mandate drives up the cost of labor, and therefore increases unemployment; delaying the mandate by one year may modestly mitigate that disincentive.

Most importantly, the delay of the mandate means that more people will want to enroll in subsidized insurance exchanges. Every year, fewer and fewer employers offer health coverage; given one more year to restructure their workforces, this process could accelerate.

There’s been a lot of debate as to whether or not the PPACA incentivizes employers to drop coverage for their employees. A 2011 survey of employers by McKinsey & Co. found that 30 percent of employers “definitely or probably” would stop offering coverage after 2014; among those who felt that they had the most knowledge of the law’s inner workings, that number rose to 50 percent.

However, the Congressional Budget Office, in a 2012 report, argued that employers do not have a large incentive to dump workers’ coverage. And even if employers dropped coverage for an additional 20 million workers relative to the CBO’s projections, the deficit would not increase, says the CBO, because the subsidies paid to low-income workers would be offset by an increase in tax revenue from lower utilization of the tax exclusion for employer-sponsored insurance.

In general, it would appear that with the rollout of PPACA exchanges in 2014, paired with a delay of the employer mandate until 2015, many more people may enroll in the exchanges. This is both good and bad: good, because it’s a good thing for people to buy insurance on their own, rather than having it bought on their behalf by someone else with their money; bad, because the exchanges are proving to be quite costly, though comparable in cost to premiums in the employer-sponsored market today.

Does Obama have the legal authority to delay the mandate?

The Affordable Care Act is quite clear as to the effective date of the employer mandate. “The amendments made by this section shall apply to months beginning after December 31, 2013,” concludes Section 1513.

The executive branch is charged with enforcing the law, and it can of course choose not to enforce the law if it wants. But people can sue the federal government, and a judge could theoretically force the administration to enforce the mandate.

So the question is: Would anyone sue the Obama administration over this? Employers, of course, will be thrilled to be spared the mandate for one more year. Democratic politicians, similarly, will be glad to have this not hanging over their heads for the 2014 mid-term election.

The wild-card is left-wing activists. Most, you’d think, would defer to the administration on questions of implementation. I’m no lawyer, but it seems to me that all it would take is for one judge to issue an injunction, for an activist to require the administration to enforce the mandate.

The employer mandate is bad policy and should be eliminated. But the unilateral way the WH is doing it isn’t good.

— Ezra Klein (@ezraklein) July 2, 2013

Delay could help to unravel the employer-sponsored insurance market

Health wonks of every persuasion, myself included, have long argued that the original sin of the U.S. health-care system is the quirk in the tax code that incentivizes people to get health coverage through their employers, instead of shopping for it on their own.

If you like the PPACA, and you want it to work, you don’t need the employer mandate. Democrats put the employer mandate in the Affordable Care Act because the President was worried that, without a mandate, employers would dump coverage, violating his oft-repeated promise that “if you like your plan, you can keep it.” Before Mitt Romney signed Massachusetts’ health-reform bill into law, he vetoed that state’s employer mandate. The heavily Democratic legislature overrode his veto.

Even if the Obama administration’s delay lasts for only one year, that delay will give firms time to restructure their businesses to avoid offering costly coverage, leading to an expansion of the individual insurance market and a shrinkage of the employer-sponsored market. Remember that the administration is not delaying the individual mandate, which requires most Americans to buy health coverage or face a fine.

But delaying the employer mandate could lead, ultimately, to its repeal, which would do much to transition our insurance market from an employer-sponsored one to an individually-purchased one. Indeed, earlier this year, a bill to do just that was introduced by Rep. Charles Boustany (R., La.) and Sen. Orrin Hatch (R., Utah). If the employer mandate were to ultimately be repealed, or never implemented, today’s news may turn out to be one of the most significant developments in health care policy in recent memory.

 

by 6d-destani

Have Fun and Stay Safe this Fourth of July with these Tips, Fun Facts and Food

The most important thing to remember this Fourth of July is the safety of you and others around you. Celebrate Independence Day with friends and family while staying safe and responsible. Here is almost everything you need to know to be safe, eat well, and have fun!

11 Tips for a Safe Fourth of July

Source: https://www.medicinenet.com

Be a safe swimmer. Water sports and fireworks are two of the biggest pastimes for Fourth of July celebrations, and these are both linked to numerous deaths and injuries each year. Never swim alone, and make sure that kids' water play is adequately supervised at all times. Manydrownings occur when parents and other adults are nearby, so always have a designated chaperone for water play and don't assume that others are watching the kids. Statistics show that most young children who drown in pools have been out of sight for less than five minutes.

Fireworks Safety. If fireworks are legal in your community and are a part of your celebration, be sure to store and use them safely. Keep the kids away from the fireworks at all times, and keep spectators at a safe distance. Attending fireworks displays organized by professionals is always safer than trying to put on your own show.

Use alcohol responsibly. Alcohol and fireworks can be a hazardous and dangerous combination. Also, have a designated driver to bring party goers home from the festivities. Remember also that alcohol and swimming can be as dangerous as drinking and driving.

Boat Safety. Lakes, waterways, and seas will be crowded with boats. Review safe boating practices, and don't drink and drive your boat. Alcohol consumption while operating boats or other motorized water vessels is illegal, and you can be arrested for a BWI (boating under the influence!). Be sure that you have an adequate number of life preservers on hand for extra guests. Become familiar with the boating laws in your area.

Cover food and beverages outdoors to discourage bees and wasps from attending your party. If someone is allergic to insect stings, you should have an emergency anaphylaxis kit on hand. Wearing shoes, long sleeves, and long pants outdoors and avoiding fragranced body products, bright colors, and sugary drinks can also help prevent bee stings.

Apply sunscreen both before and during an outdoor party. Ultraviolet rays from the sun can cause both premature aging and skin cancer in the long term, and a painful burn the next day. Even those with darker skin should use a sunscreen with a minimum sun protection factor (SPF) of 15, according to recommendations from the American Academy of Dermatology.

Check prescription medications you are taking to assure you will not have a sun-sensitizing drug reaction to the medication.

Camping/Hiking Safety. If you'll be hiking or camping in an area where ticks are abundant, wear long-sleeved, light-colored shirts and long pants tucked into socks or boots to protect yourself from tick-borne diseases. For your skin, you can use a tick repellent with no more than 30% DEET according to the manufacturer's instructions. Products containing DEET should not be used on children less than 2 months of age and should not be applied to the hands or face of young children. Check yourself (and your pets) for ticks at the end of the day.

Heat & Hydration Awareness. Spend adequate time indoors or in the shade and drink plenty of fluids to avoid heat illness in extremely hot climates. The risk of heat illness is increased when participating in strenuous activity or sports, and those with chronic medical conditions and the elderly are also at an increased risk of heat exhaustion and/or heat stroke. Alcohol consumption can also promote dehydration and increase the risk.

Keep children away from campfires and grills. Gas leaks, blocked tubes, and overfilled propane tanks can be a cause of grill fires and explosions.

Don't leave the picnic spread out all day. Allowing food to sit in outdoor temperatures can invite foodborne illness. The U.S. FDA suggests never leaving food out for more than one hour when the temperature is above 90 F and not more than two hours at other times. Foods that need to be kept cold should be placed in a cooler with plenty of ice or freezing packs and held at a maximum temperature of 40 F. While mayonnaise and other egg dishes are often associated with food poisoning, any food can potentially become contaminated. Adequate hand washing and food preparation can also help prevent food poisoning.

The Fourth of July 2013

On this day in 1776, the Declaration of Independence was approved by the Continental Congress, setting the 13 colonies on the road to freedom as a sovereign nation. As always, this most American of holidays will be marked by parades, fireworks and backyard barbecues across the country.

2.5 million

In July 1776, the estimated number of people living in the newly independent nation.
Source: Historical Statistics of the United States: Colonial Times to 1970
<https://www2.census.gov/prod2/statcomp/documents/HistoricalStatisticsoftheUnitedStates1789-1945.pdf>

316.2 million

The nation's estimated population on this July Fourth.
Source: U.S. and World Population Clock <https://www.census.gov/popclock/>

Fireworks

$218.2 million

The value of fireworks imported from China in 2012, representing the bulk of all U.S. fireworks imported ($227.3 million). U.S. exports of fireworks, by comparison, came to just $11.7 million in 2012, with Israel purchasing more than any other country ($2.5 million).

$231.8 million

The value of U.S. manufacturers' shipments of fireworks and pyrotechnics (including flares, igniters, etc.) in 2007.
Source: 2007 Economic Census, Series EC0731SP1, Products and Services Code 325998J108 <https://www.census.gov/econ/census07/>

Flags

$3.8 million

In 2012, the dollar value of U.S. imports of American flags. The vast majority of this amount ($3.6 million) was for U.S. flags made in China.
Source: Foreign Trade Statistics <https://www.census.gov/foreign-trade/www/>
<https://www.usatradeonline.gov>

$614,115

Dollar value of U.S. flags exported in 2012. Mexico was the leading customer, purchasing $188,824 worth.
Source: Foreign Trade Statistics <https://www.census.gov/foreign-trade/www/>
<https://www.usatradeonline.gov>

$302.7 million

Dollar value of shipments of fabricated flags, banners and similar emblems by the nation's manufacturers in 2007, according to the latest published economic census statistics.
Source: 2007 Economic Census, Series EC0731SP1, Products and Services Code 3149998231
<https://www.census.gov/econ/census07/>

Fourth of July Cookouts

65.9 million

Number of all hogs and pigs on March 1, 2013. Chances are that the pork hot dogs and sausages consumed on the Fourth of July originated in Iowa. The Hawkeye State was home to 20.3 million hogs and pigs. North Carolina (8.9 million) and Minnesota (7.8 million) were also homes to large numbers of pigs.
Source: USDA National Agricultural Statistics Service,
<https://usda01.library.cornell.edu/usda/current/HogsPigs/HogsPigs-03-28-2013.pdf>

6.3 billion pounds

Total estimated production of cattle and calves in Texas in 2012. Chances are good that the beef hot dogs, steaks and burgers on your backyard grill came from the Lone Star State, which accounted for nearly one-sixth of the nation's total production. And if the beef did not come from Texas, it very well may have come from Nebraska (estimated at5.1 billion pounds) or Kansas (estimated at 3.8 billion pounds).
Source: USDA National Agricultural Statistics Service
<https://usda01.library.cornell.edu/usda/current/MeatAnimPr/MeatAnimPr-04-25-2013.pdf>

6

Number of states in which the value of broiler chicken production was estimated at $1 billion or greater between December 2011 and November 2012. There is a good chance that one of these states — Georgia, Arkansas, North Carolina, Alabama, Mississippi or Texas — is the source of your barbecued chicken.
Source: USDA National Agricultural Statistics Service
<https://usda01.library.cornell.edu/usda/current/PoulProdVa/PoulProdVa-04-29-2013.pdf>

345 million

Acreage planted of potatoes in Idaho in 2012, the most in the nation. Washington followed with 165 million acres. The total 2012 potato crop is forecast to exceed 467 million hundredweight (cwt), the highest level since 2000 when 523 million cwt was produced. Potato salad is a popular food item at Fourth of July barbecues.
Source: USDA, National Agriculture Statistics Service, Economic Research Service
<https://usda01.library.cornell.edu/usda/current/CropProdSu/CropProdSu-01-11-2013.pdf>
<https://www.ers.usda.gov/publications/vgs-vegetables-and-pulses-outlook/vgs353.aspx>

Source: https://www.census.gov

Fourth of July American Recipes

Recipes from Famous Americans

Healthy Recipes

  • Diabetes Recipes (PDF)  – Tasty Recipes for People with Diabetes and Their Families is a book filled with healthy Latin American recipes.
  • Farmer's Market Recipes  – Ideas to prepare seasonal food found at the farmers' market.
  • Healthy Recipes  – Healthy meals for you and your family.
  • Heart Healthy Recipes  – Heart healthy recipes from appetizers to dessert.

Kids' Recipes

Cooking for a Crowd

Regional Recipes

  • Jersey Fresh Recipes  – Recipe ideas for fresh, seasonal produce.
  • International Recipes  – Americans trace their family origins to countries around the world. These ethnic traditions are reflected in the diversity of our recipes.

Wild Game Recipes

Source: https://www.usa.gov

by 6d-destani

White House delays employer mandate requirement until 2015

Originally posted by Sarah Kliff on https://www.washingtonpost.com

The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday.

Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015.

The administration said it would postpone the provision after hearing significant concerns from employers about the challenges of implementing it.

“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark Mazur, Assistant Secretary for Tax Policy, wrote in a late Tuesday blog post. “We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so.”

The Affordable Care Act requires all employers with more than 50 full-time workers provide health insurance or pay steep fines. That policy had raised concerns about companies downsizing their workforce or cutting workers’ hours in order to dodge the new mandate.

In delaying the enforcement of that rule, the White House sidesteps those challenges for one year. It is also the second significant interruption for the Affordable Care Act, following a one-year delay on key functions of the small business insurance marketplaces.

Together, the moves could draw criticism that the administration will not be able to put into effect its signature legislative accomplishment on schedule.

by 6d-destani

DOMA ruling complicates benefits administration

Originally posted by Andrea Davis on https://ebn.benefitnews.com

The Supreme Court’s decision striking down the federal Defense of Marriage Act is being hailed as a huge victory for same-sex couples, but the ruling makes benefits administration for employers even more complicated than before.

“It’s not even crystal clear that anybody knows what the right legal answer is with respect to those people living in the 38 states that don’t recognize same-sex marriage,” says Todd Solomon, a partner in the employee benefits practice of McDermott, Will & Emery, and author of Domestic Partner Benefits: An Employer’s Guide. “It’s really easy in the other 12 states [that do recognize same-sex marriage] — that’s what we know — but we’ve got a huge, open $64,000 question with respect to the rest of the people. And that’s a big problem for employers. I think they’re going to be very puzzled and they’re going to want guidance from the IRS.”

The court decision notes there are over 1,000 federal laws containing provisions specifically applicable to spouses that will be affected by its ruling. At this point, the ruling makes it harder for multistate employers to administer benefits, believes Leslye Laderman, a principal in the Knowledge Resource Center with Buck Consultants.

“We don’t know, exactly, the full implications of the ruling,” she says. “In the Windsor case, the plaintiff, Edith Windsor, lived in New York. New York is a state that recognizes same-sex marriage and the court very much was looking at that, and that DOMA was stepping on the rights of states to regulate that. But it really isn’t clear from the ruling exactly what the implications are for someone who’s living in a state that does not recognize same-sex marriage. More guidance is needed.”

For employees who were married in states that recognize same-sex marriage and still reside there, however, the DOMA ruling “is a significant gain in rights both on the pension side and on the health benefits side,” says Solomon.

For others, the decision “leaves many questions to be resolved by subsequent regulation and undoubtedly litigation,” said George W. Schein, lawyer with Thompson Hine’s employee benefits and executive compensation practice, in a statement. “Conspicuously unresolved is the interplay between the states that recognize same-sex marriage and those that do not.”

Retirement plans

With respect to defined benefit plans, same-sex spouses will now be entitled to survivor annuity rights. “Say a participant turns 65 and retires under a pension plan, including a frozen plan, and their benefit was $1,000 a month. If they die and have a surviving spouse, the surviving spouse would get a benefit of $500 a month – at least half of the participant’s annuity – for the rest of their life,” explains Solomon. “That’s a significant survivor benefit.”

With the DOMA ruling, this survivor benefit also now applies to qualified pre-retirement survivor annuities. “If somebody dies pre-retirement – before they start drawing their pension – that means their surviving spouse gets at least 50% of their benefit for the [duration of the] surviving spouse’s life,” says Solomon.

Combined, these survivor annuity rights represent “a big gain for same-sex couples, a pretty significant benefit that they were previously typically excluded from,” says Solomon.

Under 401(k) plans, spouses are automatically deemed beneficiaries so the DOMA decision means same-sex spouses will now have beneficiary rights they weren’t previously entitled to.

Health plans

For self-funded employers, there’s never been an obligation to cover same-sex spouses, although many plans do, says Solomon. But because DOMA defined marriage as between one man and one woman, “a lot of employers relied on the DOMA definition and said ‘we’re only covering opposite-sex spouses under our plan,’” he says. With DOMA ruled unconstitutional, it now “gets very difficult for an employer [in any state] to deny coverage to a same-sex spouse in a self-funded plan.”

Self-insured plans will “really need to think about extending coverage to same-sex spouses or be at risk of discrimination claims,” says Solomon.

Insured plans, meanwhile, “are already accustomed to covering same-sex spouses in states that recognize same-sex marriage,” says Solomon. “But with respect to other states, to the extent they’re not extending coverage, they’ll have to extend coverage as well, presumably.”

Tax implications

Since DOMA’s been struck down, health coverage for same-sex partners will no longer be a taxable benefit under federal tax law. One of the important questions is whether the decision will have retroactive implications. “A lot of employers have structured their payroll taxes and benefit plan side of things in accordance with DOMA and will now need to think through what their reactions will be,” says Joanne Youn, an employee benefits attorney at Caplin & Drysdale.

“Many constitutional cases do have retroactive implications,” notes Solomon. “In terms of tax refunds, I think you could potentially see a number of employees filing for tax refunds for taxation of benefits, and you may see employers filing for Social Security tax refunds because employers pay payroll taxes on the income they impose on employees covering same-sex spouses.”

It’s not clear retroactivity applies as the Supreme Court did not specifically address it but “it’s an open question and one that I think will be pursued – how far does this go back and will employers see an uptick in claims for spousal death benefits, for example?” says Solomon.

Next steps

Solomon recommends four steps for employers:

1. Take stock. Look at what you do already for same-sex spouses, compare it to what’s legally required now and see what gaps exist. “Some employers are going to have small gaps and some are going to have fairly large gaps,” he says.

2. Figure out how to implement any new benefits as soon as possible. “Some of this presumably takes effect right now so, for example, putting in procedures so that if somebody with a same-sex spouse were to die tomorrow, how would you treat that? Make sure you understand the rules and have policies in place,” he says.

3. Get everything documented. “From a qualified benefit plan perspective, typically you have until the end of the year to make discretionary amendments and conforming amendments,” says Solomon. “The IRS might issue some guidance and give more time but, I would aim to amend plans by the end of this calendar year, for calendar-year plans, and certainly by the end of the plan year for other plans.”

4. Update tax policies and payroll procedures to start taxing benefits in accordance with the new rules. “Stop taxing the benefits for federal income tax purposes starting as soon as possible,” says Solomon.

“It’s hard because none of this is going to happen overnight but I think employers just have to do their best to get geared up to address seemingly quite a few issues,” says Solomon. “It’s a little more complicated now than it was before, actually.”

‘Don’t be first out the gate’

Before employers communicate anything to employees, it’s important to think through the issues “and not be the first one out of the gate with extensive communications on what this means,” says Solomon.

“The important thing is to not say too much until employers figure out how they’re going to handle some of the open questions,” he says. “What happens if someone is married in New York [which recognizes same-sex marriage] but lives in Florida [which does not recognize same-sex marriage]? Is the employer going to continue to tax them on the benefits, treating them as unmarried because they live in Florida? Or will they not tax the benefit because the state of ceremony should govern and that’s good enough? Employers need to make up their mind on that, and there’s no guidance to know what the legally correct answer is on that.”

Employers should expect questions, says Roberta Chevlowe, a senior counsel in Proskauer’s employee benefits, executive compensation and ERISA litigation practice center and a member of the firm’s DOMA taskforce. However, she cautions “employers will need to consider carefully the scope of the decision and various issues relating to the implementation and effective date of the decision with regard to these issues.”

COBRA, FMLA

The ruling could also have implications for spousal rights under other legislation, such as COBRA and the Family and Medical Leave Act.

“If someone’s living in a state that recognizes same-sex marriage and has a same-spouse, now the spouse will have full COBRA rights,” says Laderman. “What we don’t know is what happens in a state where they don’t recognize same-sex marriage? An employer can extend COBRA-like coverage to same-sex spouses even if the state doesn’t recognize the marriage but it does raise issues.”

Similarly, FMLA is a federal law and rights are extended to spouses. “Are employers required to [recognize same-sex spouses] in other states [that don’t recognize same-sex marriage]? We don’t know that, but an employer could certainly extend that type of coverage if it wanted to,” says Laderman.

 

by 6d-destani

Final birth control rule issued for faith groups

Posted by Kathryn Mayer on https://www.benefitspro.com

The Obama administration isn't backing off its position that employers must include free contraceptive coverage in workers’ insurance plans as part of the nation's health care reforms, though it did give churches some wiggle room Friday.

Under pressure from religious groups, the administration issued final rules on the birth control mandate in the Patient Protection and Affordable Care Act that included a compromise allowing faith-based nonprofits and corporations to offer contraceptives through special third-party policies, without having to manage or pay for the services directly.

The mandate requires most other employers to cover a range of birth-control methods in their health plans without charging a co-pay or a deductible.

Under the final rules, religious nonprofits may notify their carrier that they object to birth control coverage. The carrier then notifies affected employees separately that it will provide coverage at no cost.

Religious groups have strongly opposed the rule, and dozens of lawsuits against the federal government have been filed. But the administration — supported by women's rights advocates — has largely stuck to its original position in favor of a contraception mandate, saying it gives women control over their health care.

Though the final rule aims to appease religious groups by setting up a system for insurers to provide the coverage separately, it's doubtful that lawsuits over the issue will stop. On Thursday, a federal appeals court ruled that Hobby Lobby could challenge PPACA on faith grounds, giving more hope to opponents of the law's mandate.

The Becket Fund for Religious Liberty, which has represented plaintiffs in some of court challenges, said the rule would not satisfy the opposition.

But Health and Human Services Secretary Kathleen Sebelius insisted Friday the final rules “strike the appropriate balance” between respecting those religious considerations and increasing access to important preventive services for women.

“The health care law guarantees millions of women access to recommended preventive services at no cost,” Sebelius said in a statement.

“Today’s announcement reinforces our commitment to respect the concerns of houses of worship and other nonprofit religious organizations that object to contraceptive coverage, while helping to ensure that women get the care they need, regardless of where they work.”

The final rule offers a simpler definition of “religious employer” for purposes of the exemption from the contraceptive coverage requirement in response to concerns raised by some religious organizations.

These employers, primarily churches, may exclude contraceptive coverage from their health plans for their employees and their dependents.

Women at nonprofit, religious-based organizations — such as at certain hospitals and universities — will have the ability to receive contraception through the separate health policies at no cost.

Announced early last year, the original mandate required most employers, including religious-affiliated organizations, to cover a range of birth control methods.

That triggered intense pushback from Catholics and other religious groups that oppose birth control, and who called the mandate an attack on their religious freedom.

On the other hand, proponents of the mandate argue that the requirement is a "win" for women, and will help reduce unplanned pregancies and abortions.

“The magic combination of responsible public and private policies and responsible behavior on the part of men and women can make all the difference in helping reduce unplanned pregnancy and improving the education and employment prospects of women and their families," Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy, said last year.

The Catholic Church has yet to respond to the final rules.

 

 

by 6d-destani

House bill would change PPACA definition of full-time employee

Originally posted by Jerry Geisel on https://www.businessinsurance.com

Legislation introduced in the House of Representatives last Friday would ease the health care reform law's definition of a full-time employee, shielding more employers from a stiff financial penalty imposed by the law.

Under the Patient Protection and Affordable Care Act, employers are required effective in 2014 to offer qualified coverage to full-time employees — defined as those working an average of 30 hours per week — or be liable for a $2,000 penalty per employee.

The legislation, H.R. 2575, introduced by Rep. Todd Young, R-Ind., would change the definition of full-time employees to those working an average of 40 hours per week.

Repealing the 30-hour definition of a full-time employee “and restoring it to the historical norm ensures this bill not only protects working poor and middle class employees, it also ensures that laws governing employment are consistent,” Rep. Young said in a statement.

The introduction of the measure comes one year to the day of the 2012 U.S. Supreme Court ruling upholding the constitutionality of the health care reform law provision requiring most Americans to enroll in a health care plan or pay a tax, effective Jan. 1, 2014.

by 6d-destani

The 4-Minute Workout

Originally published by Gretchen Reynolds on The New York Times health blog.

Thanks to an ingratiating new study, we may finally be closer to answering that ever-popular question regarding our health and fitness: How little exercise can I get away with?

The answer, it seems, may be four minutes.

For the study, which was published last month in the journal PLoS One, researchers from the Norwegian University of Science and Technology in Trondheim, Norway, and other institutions attempted to delineate the minimum amount of exercise required to develop appreciable endurance and health gains. They began by reconsidering their own past work, which had examined the effects of a relatively large dose of high-intensity intervals on various measures of health and fitness.

For those unfamiliar with the term, high-intensity intervals are just that: bursts of strenuous exercise lasting anywhere from 30 seconds to several minutes, interspersed with periods of rest. In recent years, a wealth of studies have established that sessions of high-intensity exercises can be as potent, physiologically, as much longer bouts of sustained endurance exercise.

In a representative study from 2010, for instance, Canadian researchers showed that 10 one-minute intervals — essentially, 10 minutes of strenuous exercise braided with one-minute rest periods between — led to the same changes within muscle cells as about 90 minutes of moderate bike riding.

Similarly, the Norwegian scientists for some years have been studying the effects of intense intervals lasting for four minutes, performed at about 90 percent of each volunteer’s maximum heart rate and repeated four times, with a three-minute rest between each interval. The total meaningful exercise time in these sessions, then, is 16 minutes.

Which, the researchers thought, might just be too much.

“One of the main reasons people give” for not exercising is that they don’t have time, says Arnt Erik Tjonna, a postdoctoral fellow at the Norwegian University of Science and Technology, who led the study.

So he and his colleagues decided to slim down the regimen and determine whether a single, strenuous four-minute workout would effectively improve health and fitness.

To do so, they gathered 26 overweight and sedentary but otherwise healthy middle-aged men, determined their baseline endurance and cardiovascular and metabolic health, and randomly assigned them to one of two groups.

Half began a supervised exercise program that reiterated the Norwegian researchers’ former routine. After briefly warming up, these volunteers ran on a treadmill at 90 percent of their maximal heart rate — a tiring pace, says Dr. Tjonna, at which “you cannot talk in full sentences, but can use single words” — for four four-minute intervals, with three minutes of slow walking between, followed by a brief cool-down. The entire session was repeated three times a week for 10 weeks.

The second group, however, completed only one four-minute strenuous run. They, too, exercised three times a week for 10 weeks.

At the end of the program, the men had increased their maximal oxygen uptake, or endurance capacity, by an average of 10 percent or more, with no significant differences in the gains between the two groups.

Metabolic and cardiovascular health likewise had improved in both groups, with almost all of the men now displaying better blood sugar control and blood pressure profiles, whether they had exercised vigorously for 16 minutes per session, or four minutes per session, and despite the fact that few of the men had lost much body fat.

“This is not a weight-loss program,” Dr. Tjonna says. It is, instead, he says, “a suggestion for how people can make a kick-start for better fitness,” or maintain fitness already gained, when other obligations press on your time.

The results, Dr. Tjonna says, persuasively suggest that “getting in shape does not demand a big effort” in terms of time.

That finding, though, inevitably raises the question of whether the bar could drop even lower. Could, for instance, a mere two minutes of strenuous training effectively improve health and fitness?

Dr. Tjonna, the killjoy, doubts it. There are other groups of scientists looking at even shorter bouts of exercise, he says, “but it seems like they don’t get the same results regarding the maximal oxygen uptake” as the four-minute sessions used in his experiment. Since improved maximal oxygen uptake can reliably indicate better overall cardiovascular health, he suspects that “we need a certain length of the interval to trigger” such health and fitness benefits.

Thankfully, for those worried that a trip to the gym is an inefficient means of completing four minutes of exercise, the workout can effectively be practiced anywhere, Dr. Tjonna says. Sprint uphill for four minutes or race up multiple flights of steps. Bicycle, swim or even walk briskly, as long as you raise your heart rate sufficiently for four minutes. (Obviously, consult your doctor first if you haven’t been active in the past.)

“Everyone, we think,” Dr. Tjonna says, “has time for this kind of exercise three times a week.”

Special thanks to the Reduced Shakespeare Company and Christopher McDougall for their contributions to the Well 4-Minute Workout playlist.

 

by 6d-destani

Now What? Employer Benefits Obligations Post-DOMA

Originally posted by Stephen Miller on https://www.shrm.org

On June 26, 2013, the U.S. Supreme Court, in United States v. Windsor, found unconstitutional Section 3 of the federal Defense of Marriage Act (DOMA), which had prohibited the federal government from acknowledging marriages between same-sex couples. Same-sex marriages were recognized as legal by 12 states and the District of Columbia at the time of the ruling. In a related case, Hollingsworth v. Perry, the court ruled that those challenging a California state court decision that made same-sex marriage legal in California (by overturning a state ballot initiative known as Proposition 9) lacked standing to do so—a finding that will restore legal same-sex marriage in the state.

“The Windsor decision is as many expected," Roberta Chevlowe, senior counsel in law firm Proskauer's employee benefits practice center in New York, told SHRM Online. "While the court held that Section 3 of DOMA (which defines 'marriage' and 'spouse' as excluding same-sex partners) is unconstitutional on equal-protection grounds, the decision does not force same-sex marriage on the states, which appear to continue to be free to define marriage as they wish and not recognize same-sex marriage."

For employers, "the Windsor decision means that there is much work to do with regard to the employer's benefit plans, even for employers who do not operate in states that recognize same-sex marriage," Chevlowe added. "On the health benefits side, among other things, employers will need to revisit the definition of 'spouse' in their plans to ensure that the definition is consistent with the employer's intent, in light of the decision. Employers may also need to cease imputing income to employees for the value of the health benefits they provide to same-sex spouses. With regard to qualified pensions, plan language and procedures will need to be considered because same-sex spouses have additional rights to federally protected benefits."

In addition, "Employers should expect that employees will immediately start asking questions about their rights with regard to various employee benefits, and employers will need to consider carefully the scope of the decision and various issues relating to the implementation and effective date of the decision with regard to these issues,” Chevlowe said.

Expanded Obligations

In an e-mail, Todd Solomon, an employee benefits partner at law firm McDermott Will & Emery LLP in Chicago, identified the following as key benefits implications for private-sector organizations (but not necessarily state government and church employers) now that Section 3 of DOMA has been struck down.

For a legally married couple who live in a state where same-sex marriage is recognized:

  • Federal laws governing employee benefit plans will require companies to treat employees’ same-sex and opposite-sex spouses equally for purposes of the benefits extended to spouses.
  • Employers with self-insured welfare plans (meaning benefits are paid out of the company’s general assets) may not have to extend spousal-benefit coverage to same-sex spouses, because federal law does not require spousal welfare-benefit coverage and because state insurance law mandates do not apply to self-insured plans. However, employers that continue to provide benefit coverage only to opposite-sex spouses "are almost certain to face legal challenges under federal discrimination law," Solomon advised.
  • Employees will no longer have to pay federal income taxes on the income imputed for an employer’s contribution to a same-sex spouse’s medical, dental or vision coverage. And workers can pay for same-sex spouses’ coverage on a pretax basis under a Section 125 plan.
  • Businesses will have to offer COBRA continuation coverage to same-sex spouses.
  • Employers with pension plans will be required to recognize same-sex spouses for purposes of determining surviving-spouse annuities. Same-sex spouses must also agree to receive payment of their deceased spouse’s pension benefits in a form other than a 50 percent joint and survivor annuity, with the same-sex spouse as the beneficiary.
  • Organizations with 401(k) plans will have to recognize same-sex spouses for purposes of determining death benefits, and same-sex spouses must consent to beneficiary designations.
  • Employees must be permitted to take family and medical leave to care for an ill same-sex spouse.

"The above rules only apply to same-sex spouses who were married in and live in a state where same-sex marriage is legal,” Solomon clarified. “The big open question is what happens to same-sex spouses who live in states such as Florida or Texas," which don't recognize same-sex marriages. "No one can answer the question until additional guidance is issued. It is possible that the answer can vary for different purposes—for example, state of residence will likely carry the day for tax filing and imputed income purposes, but it is possible the IRS could say that 'state of celebration' governs for pension plan purposes. In the meantime, it appears that employers can choose either approach, but it will be imperative to amend plans to add clear plan language to document the employer's approach."

The decision "will affect retirement plan administration because plans will have to obtain the consent of the same-sex spouse to permit a waiver of the qualified joint and survivor annuity (QJSA) form of benefit or for any other purposes for which the consent of an opposite-sex spouse is required," in states that recognize same-sex marriages, concurred Leslye Laderman and Marjorie Martin, principals at Buck Consultants LLC. "It is unclear from theWindsor ruling whether employers will be required, or permitted in the case of the QJSA, to recognize same-sex spouses of employees living in states that do not recognize same-sex marriages as spouses for purposes of these laws. Additional guidance is needed."

Retroactive Benefits

Another question is whether employees can claim benefits retroactively—for instance, seeking past tax relief for spousal health care benefits—if they've been married to their same-sex spouse in a state that recognizes same-sex marriage. Solomon observed: "It is certainly not clear yet, but I would think employees should be able to amend tax returns for open years to claim refunds. And employers should be able to get refunds of FICA taxes for prior open years."

Retroactivity “is one of the most important practical questions facing employers and plan sponsors" following the DOMA ruling, added Joanne Youn, an ERISA and benefits law attorney at Caplin & Drysdale in Washington, D.C. "While the court did not specifically address retroactivity broadly, the decision arose out of a claim for refund of estate taxes paid by a same sex-spouse in a prior tax year. The IRS has authority under existing law to grant relief from retroactivity; however, even if it were to do so, its authority would not extend to other statutes affecting employee benefits, such as ERISA. The decision itself references the fact that over 1,000 federal laws contain provisions specifically applicable to spouses that may be affected and should be coordinated. Therefore, I would expect that additional guidance will be issued in the coming months.”

Deferring to State Law

Rita F. Lin, a partner at Morrison Foerster in San Francisco, said that many federal laws governing spousal benefits do not contain a statutory definition indicating which law governs whether an individual is “married.”

"Typically, federal laws defer to state law on this issue,” Lin explained, “but it will often be an open question under choice-of-law principles whether the applicable state law is the law of the state in which the couple was married or the state in which the couple currently resides. Some federal statutes (e.g., Social Security) look to whether a couple is married at the time that benefits are sought, which may suggest that the law of the state of current residence will apply. Others (in the immigration context) look to the state where the couple was married."

Lin revealed that there are "rumors that the administration may be considering an executive order that directs federal agencies, in interpreting federal statutes, to treat the state where the marriage celebration occurred as the governing state for purposes of determining whether couples are married.” She added: “I would note that, though there may be some short-term confusion, this is not technically a new issue. The states vary in their definitions of marriage on issues like common-law marriage, first-cousin marriage and age of eligibility, so this could always be an issue when married couples move to a new state that does not recognize their marriage. Of course, the issue is now going to be presented on a much larger scale than before, so we may see an attempt to resolve this in a more uniform fashion."

Presidential Action

Similarly, Hunter T. Carter, a litigation partner at Arent Fox in New York and Washington, D.C., said: "The president is crucial to implement the Supreme Court decision overturning DOMA, and employers will be watching to see what the president does. Everywhere he can do so, President Obama is expected to approve regulations and interpretations that apply the term 'spouse' to same-sex couples who were legally married, regardless where the couple was from or has moved."

Changing regulations that define "spouse" may take longer than an executive order, Carter said, "but again, President Obama will be crucial. Currently, the IRS and Social Security determine marriage status by where the couple lives, not where they married, so anyone in the 38 states that don't yet recognize or allow same-sex marriage will be unmarried for IRS and Social Security purposes until regulations can be changed. This is true even though they are otherwise identical to their neighbors who may have married in another state, like New York, which also allows same-sex marriage. Other agencies will not need to change, like the Defense Department, which interprets marital status based on where the couple was married."

 

by 6d-destani

Volunteering linked to better physical, mental health

Originally posted by Andrea Davis on the Employee Benefit News website.

Three-quarters of volunteers say volunteering has made them feel physically healthier and lowered their stress levels, according to a new study released today by UnitedHealth Group and the Optum Institute. The study also illustrates that employers benefit from employees who volunteer in terms of better employee health and in professional skills development that employees use in the workplace.

Volunteers are also more engaged in their health than non-volunteers, with 80% of the people who’ve volunteered in the past 12 months saying they feel they have control over their health. Moreover, about one-quarter of the people who’ve volunteered in the past month say that volunteering has helped them to manage a chronic illness.

In addition to physical and mental health benefits, employees who volunteer say doing so has helped them learn valuable business skills. Sixty-four percent of employees who currently volunteer said that volunteering with work colleagues has strengthened their relationships, while three-quarters of people who say that volunteering helped their career report that volunteering has helped them refine existing professional skills and build new ones.

“Employers enjoy the benefits of physically and mentally healthier employees; those that support volunteering programs in the workplace see added benefits that drive directly to their bottom line,” said Kate Rubin, vice president of social responsibility with UnitedHealth Group.

The findings are based on a national survey of 3,351 adults conducted by Harris Interactive.

 

by 6d-destani

Four tips for better benefit plan communications

Originally posted by Dani McCauley on the EBN blog.

It’s make it or break it time for employee benefit plans, suggests guest blogger Dani McCauley. She has four suggestions for better communication. Do you agree? Share your thoughts in the comments. —Andrea Davis, Managing Editor

Not to be an alarmist, but there is a convergence of events and trends that will make or break the success of many employers’ benefit plans this year. However, a spot-on communications plan will smooth the road ahead, and can even turn risks into opportunities.

Position changes properly

With the biggest health care reform provisions coming into effect in 2014, many employers are making an array of not-so-subtle changes to their benefit offerings. Such changes could range from streamlining down to fewer plan options, to significant premium differentials for wellness participation.

Whether the changes are seen as positive, negative or neutral depends on how well they’re communicated. After all, employees who are satisfied with their company benefits are more likely to be loyal to their employer, according to a recent study by MetLife. The study found that while only 42% of employees in the U.S. would strongly recommend their employer, those who do feel this way are three times more likely to be satisfied with their benefits.

Key takeaway: Taking the time to think through tough benefit messages and position changes in the best possible light will pay dividends.

Wellness
An effective wellness program represents the holy grail for group health plan sponsors seeking to actually change the health risks in their employee populations (thus mitigating costs and increasing worker productivity). Notice I said an “effective” wellness program. In order for such programs to be effective, they must be communicated in a way that helps employees to internalize the lifestyle changes they are expected to make.

For example, sending a quarterly newsletter with diet and exercise tips is likely insufficient to spark meaningful behavioral changes. Such a program is likely to succeed best if kicked-off with in-person meetings and frequent communications, possibly through a company intranet or in some other medium that keeps guidance, goals and incentives front and center for employees on a daily basis.

Key takeaway: Don’t invest in a wellness program unless you’re willing to back it up with an intensive communications plan.

Compliance confusion
Health care reform brings with it a host of new communication requirements designed to ensure that employees have equal access to benefits information, know their opt-out rights, understand the plans being offered, and more.

To take one example, the Summary of Benefits and Coveragerequirement just made benefit communications a little more complicated. While the SBC format is rigid and proscribed, employers must comply with the form’s required phrasing. But don’t rely on the SBC as your primary benefit communication document. Employers still need to communicate their overall benefits offering in a cohesive fashion. From health to retirement, your company benefits need to be explained in a way that resonates with your corporate culture, ideally unifying the entire plan behind a meaningful and relevant theme.

Key takeaway: Don’t abandon your traditional benefit communications materials. The SBC requirement is strictly an add-on.

Multi, Multi-Media
With so many options for communicating with employees, it’s important to consider what will work best for your corporate culture. If employees are spread far and wide at multiple locations, video tutorials can be a great way to reach out and educate employees who might otherwise feel disconnected at open enrollment time and year-round. Companies that are really tech-savvy might also consider social media or mass text messaging to bolster their efforts. But for other organizations where employees have limited access to the Internet throughout the day, call-center assistance might still be the best way to keep from placing certain groups of employees at a disadvantage.

Key takeaway: When it comes to communications logistics, let practicality be your guide.

Dani McCauley is senior vice president of marketing with Univers Workplace Solutions.

What methods are you using to communicate your benefits plan? Are the messages any different than in past years? Share your thoughts in the comments.

 

by 6d-destani