Compliance: Yearly Deadlines for Health Plans

Do you offer group health plans coverage to your employees? Employers that provide coverage are subject to multiple compliance requirements throughout the year. Certain requirements have been around for many years, while others have been recently added by the Affordable Care Act (ACA).

Continue reading for a summary of the many compliance requirements and their associated deadlines that health plan providers should be aware of throughout the year. Certain deadlines for non-calendar year plans may vary from what is outlined in this summary. This summary only covers recurring calendar year compliance deadlines. Other requirements that are not based on the calendar year are not included below.

January

Deadline Requirement Description

January 31

Form W-2 Deadline for providing Forms W-2 to employees. The ACA requires employers to report the aggregate cost of employer-sponsored group health plan coverage on their employees’ Forms W-2. The purpose is to provide employees with information on how much their health coverage costs. Certain types of coverage are not required to be reported on Form W-2.

This Form W-2 reporting requirement is currently optional for small employers (those who file fewer than 250 Forms W-2). Employers that file 250 or more Forms W-2 are required to comply with the ACA’s reporting requirement.

January 31 Form 1095-C or Form 1095-B—Annual Statement to Individuals Applicable large employers (ALEs) subject to the ACA’s employer shared responsibility rules must furnish Form 1095-C (Section 6056 statements) annually to their full-time employees. Employers with self-insured health plans that are not ALEs must furnish Form 1095-B (Section 6055 statements) annually to covered employees.

The Forms 1095-B and 1095-C are due on or before Jan. 31 of the year immediately following the calendar year to which the statements relate. Extensions may be available in certain limited circumstances. However, an alternate deadline generally is not available for ALEs that sponsor non-calendar year plans.

 

Update: The IRS extended the deadline for furnishing the 2018 employee statements, from Jan. 31, 2019, to March 4, 2019.  

February

Deadline Requirement Description

February 28   (March 31, if filing electronically)

Section 6055 and 6056 Reporting Under Section 6056, ALEs subject to the ACA’s employer shared responsibility rules are required to report information to the IRS about the health coverage they offer (or do not offer) to their full-time employees. ALEs must file Form 1094-C and Form 1095-C with the IRS annually.

Under Section 6055, self-insured plan sponsors are required to report information about the health coverage they provided during the year. Self-insured plan sponsors must generally file Form 1094-B and Form 1095-B with the IRS annually.

ALEs that sponsor self-insured plans are required to report information to the IRS under Section 6055 about health coverage provided, as well as information under Section 6056 about offers of health coverage. ALEs that sponsor self-insured plans will generally use a combined reporting method on Form 1094-C and Form 1095-C to report information under both Sections 6055 and 6056.

All forms must be filed with the IRS annually, no later than Feb. 28 (March 31, if filed electronically) of the year following the calendar year to which the return relates. Reporting entities that are filing 250 or more returns must file electronically. There is no alternate filing date for employers with non-calendar year plans.

March

Deadline Requirement Description

March 1   (calendar year plans)

Medicare Part D Disclosure to CMS Group health plan sponsors that provide prescription drug coverage to Medicare Part D eligible individuals must disclose to the Centers for Medicare & Medicaid Services (CMS) whether prescription drug coverage is creditable or not. In general, a plan’s prescription drug coverage is considered creditable if its actuarial value equals or exceeds the actuarial value of the Medicare Part D prescription drug coverage. Disclosure is due:

  • Within 60 days after the beginning of each plan year;
  • Within 30 days after the termination of a plan’s prescription drug coverage; and
  • Within 30 days after any change in the plan’s creditable coverage status.

Plan sponsors must use the online disclosure form on the CMS Creditable Coverage webpage.

July

Deadline Requirement Description

July 31

PCORI Fee Deadline for filing IRS Form 720 and paying Patient-Centered Outcomes Research Institute (PCORI) fees for the previous year. For insured health plans, the issuer of the health insurance policy is responsible for the PCORI fee payment. For self-insured plans, the PCORI fee is paid by the plan sponsor.

The PCORI fees are temporary—the fees do not apply to plan years ending on or after Oct. 1, 2019. This means that, for calendar year plans, the PCORI fees do not apply for the 2019 plan year.

July 31

Form 5500 Plan administrators of ERISA employee benefit plans must file Form 5500 by the last day of the seventh month following the end of the plan year, unless an extension has been granted. Form 5500 reports information on a plan’s financial condition, investments and operations. Form 5558 is used to apply for an extension of two and one-half months to file Form 5500.

Small health plans (fewer than 100 participants) that are fully insured, unfunded or a combination of insured/unfunded, are generally exempt from the Form 5500 filing requirement.

The Department of Labor’s (DOL) website and the latest Form 5500 instructions provide information on who is required to file and detailed information on filing.

September

Deadline Requirement Description

September 30

Medical Loss Ratio (MLR) Rebates The deadline for issuers to pay medical loss ratio (MLR) rebates for the 2014 reporting year and beyond is Sept. 30. The ACA requires health insurance issuers to spend at least 80 to 85 percent of their premiums on health care claims and health care quality improvement activities. Issuers that do not meet the applicable MLR percentage must pay rebates to consumers.

Also, if the rebate is a “plan asset” under ERISA, the rebate should, as a general rule, be used within three months of when it is received by the plan sponsor. Thus, employers who decide to distribute the rebate to participants should make the distributions within this three-month time limit.

September 30

Summary Annual Report Plan administrators must automatically provide participants with the summary annual report (SAR) within nine months after the end of the plan year, or two months after the due date for filing Form 5500 (with approved extension).

Plans that are exempt from the annual 5500 filing requirement are not required to provide an SAR. Large, completely unfunded health plans are also generally exempt from the SAR requirement.

October

Deadline Requirement Description

October 15

Medicare Part D – Creditable Coverage Notices Group health plan sponsors that provide prescription drug coverage to Medicare Part D eligible individuals must disclose whether the prescription drug coverage is creditable or not. Medicare Part D creditable coverage disclosure notices must be provided to participants before the start of the annual coordinated election period, which runs from Oct. 15-Dec. 7 of each year. Coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of coverage under Medicare Part D. This disclosure notice helps participants make informed and timely enrollment decisions.

Disclosure notices must be provided to all Part D eligible individuals who are covered under, or apply for, the plan’s prescription drug coverage, regardless of whether the prescription drug coverage is primary or secondary to Medicare Part D.

Model disclosure notices are available on CMS’ website.

Annual Notices

Type of Notice Description
WHCRA Notice The Women’s Health and Cancer Rights Act (WHCRA) requires group health plans that provide medical and surgical benefits for mastectomies to also provide benefits for reconstructive surgery. Group health plans must provide a notice about the WHCRA’s coverage requirements at the time of enrollment and on an annual basis after enrollment. The initial enrollment notice requirement can be satisfied by including the information on WHCRA’s coverage requirements in the plan’s summary plan description (SPD). The annual WHCRA notice can be provided at any time during the year. Employers with open enrollment periods often include the annual notice with their open enrollment materials. Employers that redistribute their SPDs each year can satisfy the annual notice requirement by including the WHCRA notice in their SPDs.

Model language is available in the DOL’s compliance assistance guide.

CHIP Notice If an employer’s group health plan covers residents in a state that provides a premium subsidy under a Medicaid plan or CHIP, the employer must send an annual notice about the available assistance to all employees residing in that state. the annual CHIP notice can be provided at any time during the year. Employers with annual enrollment periods often provide CHIP notice with their open enrollment materials.

The DOL has a model notice that employers may use.

Group health plans and health insurance issuers are required to provide an SBC to applicants and enrollees each year at open enrollment or renewal time. The purpose of the SBC is to allow individuals to easily compare their options when they are shopping for or enrolling in health plan coverage. Federal agencies have provided a template for the SBC, which health plans and issuers are required to use.

The issuer for fully insured plans usually prepares the SBC. If the issuer prepares the SBC, an employer is not also required to prepare an SBC for the health plan, although the employer may need to distribute the SBC prepared by the issuer.

The SBC must be included in open enrollment materials. If renewal is automatic, the SBC must be provided no later than 30 days prior to the first day of the new plan year. However, for insured plans, if the new policy has not yet been issued 30 days prior to the beginning of the plan year, the SBC must be provided as soon as practicable, but no later than seven business days after the issuance of the policy.

Grandfathered Plan Notice To maintain a plan’s grandfathered status, the plan sponsor or must include a statement of the plan’s grandfathered status in plan materials provided to participants describing the plan’s benefits (such as the summary plan description, insurance certificate and open enrollment materials). The DOL has provided a model notice for grandfathered plans. This notice only applies to plans that have grandfathered status under the ACA.
Notice of Patient Protections If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of patient protections whenever the SPD or similar description of benefits is provided to a participant. This notice is often included in the SPD or insurance certificate provided by the issuer (or otherwise provided with enrollment materials).

The DOL provided a model notice of patient protections for plans and issuers to use.

HIPAA Privacy Notice The HIPAA Privacy Rule requires self-insured health plans to maintain and provide their own privacy notices. Special rules, however, apply for fully insured plans. Under these rules, the health insurance issuer, and not the health plan itself, is primarily responsible for the privacy notice.

Self-insured health plans are required to send the privacy notice at certain times, including to new enrollees at the time of enrollment. Thus, the privacy notice should be provided with the plan’s open enrollment materials. Also, at least once every three years, health plans must either redistribute the privacy notice or notify participants that the privacy notice is available and explain how to obtain a copy.

The Department of Health and Human Services (HHS) has model Privacy Notices for health plans to choose from.

HIPAA Special Enrollment Notice At or prior to the time of enrollment, a group health plan must provide each eligible employee with a notice of his or her special enrollment rights under HIPAA. This notice should be included with the plan’s enrollment materials. It is often included in the health plan’s SPD or insurance booklet. Model language is available in the DOL’s compliance assistance guide.
Wellness Notice HIPAA Employers with health-contingent wellness programs must provide a notice that informs employees that there is an alternative way to qualify for the program’s reward. This notice must be included in all plan materials that describe the terms of the wellness program. If wellness program materials are being distributed at open enrollment (or renewal time), this notice should be included with those materials. Sample language is available in the DOL’s compliance assistance guide.
Wellness Notice ADA To comply with the Americans with Disabilities Act (ADA), wellness plans that collect health information or involve medical exams must provide a notice to employees that explains how the information will be used, collected and kept confidential. Employees must receive this notice before providing any health information and with enough time to decide whether to participate in the program. Employers that are implementing a wellness program for the upcoming plan year should include this notice in their open enrollment materials. The Equal Employment Opportunity Commission has provided a sample notice for employers to use.

Resources: https://www.ada.gov/; https://www.dol.gov/; https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/model-notices-privacy-practices/index.html; https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters.html; https://www.irs.gov/retirement-plans/retirement-plan-participant-notices-when-the-end-of-the-plan-year-has-passed; https://www.cms.gov/cciio/programs-and-initiatives/health-insurance-market-reforms/medical-loss-ratio.html; https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/publications/compliance-assistance-guide.pdf; https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/preexisting-condition-exclusions; https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits; https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/chipra/working-group; https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/whcra; https://www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/reporting-and-filing/forms; https://www.irs.gov/newsroom/patient-centered-outcomes-research-institute-fee; https://www.irs.gov/affordable-care-act/individuals-and-families/form-1095-b-what-you-need-to-do-with-this-form; https://www.irs.gov/affordable-care-act/individuals-and-families/form-1095-c-what-you-need-to-do-with-this-form; https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/index.html?redirect=/CreditableCoverage/; https://www.irs.gov/affordable-care-act/questions-and-answers-on-information-reporting-by-health-coverage-providers-section-6055; https://www.irs.gov/affordable-care-act/employers/questions-and-answers-on-reporting-of-offers-of-health-insurance-coverage-by-employers-section-6056; https://www.irs.gov/forms-pubs/about-form-w-2;


10 Retirement Lessons for 2019

There are lessons to be learned from recent decisions and settlements about the best ways to protect yourself in 2019. Here are some important takeaways from recent litigation activity.

1. Your Process Matters.

New York University recently got a lawsuit dismissed by a district court because it provided evidence that it followed a prudent process when selecting investments. If a case goes to trial, you will also need to demonstrate that you made prudent decisions in order to prevail.

2. Put It in Writing.

It’s hard to prove that you followed a prudent process if you don’t write down what you did. People change jobs, die or simply forget the details of what was done if there are not minutes explaining the reasons for decisions. Have clear written policies showing what you will consider when selecting or replacing investments and reviewing fees, and make sure to follow those policies.

3. Know and Review Your Options.

Complaints have alleged that fiduciaries failed to consider alternatives to common investments, such as collective trusts as an alternative to mutual funds and stable value funds as alternatives to money market funds. Employees of investment giants such as Fidelity have sued because they claimed that these companies filled their plans with their own in-house investments even though better performing alternatives with lower fees were available. Even if you don’t select these options, you should investigate them and record the reasons for your decisions. Be especially careful about choosing your vendor’s proprietary funds without investigation.

4. Understand Target Date Funds.

They have different risk profiles, performance history, fees and glide paths. Don’t take the easy way out and automatically choose your vendor’s funds. In fact, you need to have a prudent process to select these.

5. Benchmark Plan Fees.

Be able to demonstrate that your fees are reasonable for plans of your size. But don’t compare apples to oranges. Select an appropriate peer group. Remember, though, that it is not a violation of ERISA to pay higher fees for better service, so long as the fees are reasonable.

6. Retain an Expert to Help You.

Don’t be penny wise and pound foolish. If you don’t have internal investment expertise, hire an outside fiduciary to assist you. Insist on written reports of recommendations if the fiduciary is a co-adviser, and that the fiduciary attend committee meetings to answer questions and explain the recommendations.

7. Consult Outside Counsel When Necessary.

See No. 6. Don’t try to guess what the law requires, and listen to counsel’s recommendations about best practices. While both advisers and ERISA counsel are available to provide fiduciary education, your ERISA counsel can give you a better handle on your legal responsibilities as ERISA fiduciaries.

8. Hold Regular Committee Meetings.

The days when committees met once a year are over. Many committees now meet quarterly. These should be formal meetings where committee members sit down together with the plan adviser and, where appropriate, with ERISA counsel.

A secretary should take formal minutes. Plan fiduciaries shouldn’t be meeting over the water cooler or making decisions by exchanging emails without face-to-face discussion in a misguided effort to save time.

9. Review Your Providers.

At least once a year, review whether your vendors are performing in accordance with their proposals and their services agreements, and survey your committee members to determine whether they are happy with the provider’s performance. Follow up to request changes or start an RFP to find a new vendor if necessary.

10. Schedule Regular RFPs.

Even if you are happy with your current providers, new RFPs will give you the opportunity to renegotiate your services agreements and fees and will also let you know whether additional services are available in the marketplace.

content resource: https://401kspecialistmag.com


It might be time for a financial wellness checkup

Forty-six percent of employees spend two to three hours per week at work dealing with personal finances. Read this blog post to learn what employers can do if they want a stress-free and productive workforce.


We’ve all seen the infamous statistics — 56% of American workers struggle financially, 75% live paycheck to paycheck. A majority of Americans can’t come up with $1,000 for an emergency.

It is quite obvious that financial worries have a massive impact on happiness and stress levels, but what business owners, executives and human resource professionals understand is that this lack of financial wellness in the U.S. has a devastating effect on worker productivity, and therefore, employers’ bottom lines.

Employees who spend time during their day worried about bills and loans are less focused on getting their work done. In fact, a staggering 46% of employees spend, on average, two to three hours per week dealing with personal finance issues during work hours. So what can employers offer their workers to help them become more financially sound?

There are a number of ways to help employees improve their financial well-being – including utilizing the help of a financial wellness benefit platform – but at the very least, there are three major benefits that every business should employ if they want a stress-free and productive workforce.

Savings, investment and retirement solutions. Offering employees the ability to automatically allocate their paychecks into savings, investment and retirement accounts will help them more effectively meet their financial goals without worrying about moving money around. These types of programs should allow employees to make temporary or permanent changes at any time to reflect any immediate changes that may occur in their life.

Credit solutions and loan consolidation. Having a reliable source of credit is extremely important, but access to it can also be dangerous for big spenders. Employers should guide workers towards making informed financial decisions and teach them how to use credit wisely. Employers need to be able to refer employees to affordable and trusted sources for things like credit cards, short-term loan options and mortgages, so employees don’t have to spend time doing the research for themselves (or worse, potentially becoming victims of fraud). Companies should also offer resources that teach employees how to organize their finances to pay their debt off on time without accumulating unnecessary interest or fees.

Insurance (not just health). While many large companies offer the traditional health, dental, vision, disability and life insurance, employers should also be offering resources that give easy access to vehicle, home, renters, boat, pet and other common insurance products. Some insurance carriers even offer volume discounts, so if a large percentage of employees in an organization utilize pet insurance, everyone can save some money.

While it is important for employers to offer these benefits, it is also important to follow up with employees and make sure they are utilizing all of the benefits they have access to. Sometimes people can have too much pride or can be afraid to ask for financial help. The use of these programs should be talked about, encouraged and even rewarded.

Justifying the investment in these benefits is simple. Employers want to increase productivity, and employees want to be more financially sound. The workplace is evolving and so is the workforce, so while you look to add benefits like 401(k), work from home, summer Fridays, gym memberships and free lunch, don’t forget about the financial wellness of the people you employ. Maybe next year, you will see that your workers are focused less on their college loans and are able to put more effort into growing your business.

SOURCE: Kilby, D. (2 January 2019) "It might be time for a financial wellness checkup" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/it-might-be-time-for-a-financial-wellness-checkup?feed=00000152-a2fb-d118-ab57-b3ff6e310000


E-Verify Is Down. What Do Employers Do Now?

Are you questioning what you should do now that E-Verify, the federal government's electronic employment verification system, has expired? Read this blog post from SHRM to learn more.


What are employers supposed to do now that E-Verify—the federal government's electronic employment verification system—has expired?

Funding and congressional authorization for the program ran out Dec. 22, 2018, as the government went into a partial shutdown after Congress and the White House could not agree on how to fund some agencies, including the U.S. Department of Homeland Security (DHS), which administers the system, for fiscal year 2019.

E-Verify compares information from an employee's Form I-9 to DHS and Social Security Administration (SSA) records to confirm employment eligibility. Employers enrolled in the program are required to use the system to run checks on new workers within three days of hiring them.

During the government shutdown, employers will not be able to enroll in E-Verify, initiate queries, access cases or resolve tentative non-confirmations (TNCs) with affected workers.

All employers remain subject to Form I-9 obligations, however. "Remember that the government shutdown has nothing to do with an employer's responsibilities to complete the Form I-9 [in a timely manner]," said Dawn Lurie, senior counsel in the Washington, D.C., office of Seyfarth Shaw. "Specifically, employees are required to complete Section 1 of the I-9 on or before the first day of employment, and employers must complete Section 2 of the I-9 no later than the third business day after an employee begins work for pay."

No Cause for Alarm

Lurie advised employers not to panic while E-Verify is down. "Employers will not be penalized as a result of the E-Verify operations shutdown," she said. "Employers will not be penalized for any delays in creating E-Verify cases. However, employers are reminded that they must continue to complete I-9s in compliance with the law, and when E-Verify becomes available, create cases in the system."

To minimize the burden on both employers and employees, DHS announced that:

  • The three-day rule for creating E-Verify cases is suspended for cases affected by the unavailability of the service. "Normally, the employer enters information from the I-9 into E-Verify within three days of hire, but that won't be possible while the system is unavailable," said Montserrat Miller, a partner in the Atlanta office of Arnall Golden Gregory. "DHS will provide a window of time to submit those held cases once service resumes."
  • The time period during which employees may resolve TNCs will be extended. The number of days E-Verify is unavailable will not count toward the days the employee has to begin the process of resolving a TNC. "Employers can't take any adverse action against a worker with a pending TNC regardless, shutdown or not," Miller said. Currently, an employee who chooses to contest a TNC must visit an SSA field office or call DHS within eight federal government working days to begin resolving it. This period will have to be extended because of the shutdown, she added.
  • Additional guidance regarding the three-day rule and time period to resolve TNC deadlines will be provided once operations resume.

Amy Peck, an immigration attorney with Jackson Lewis in Omaha, Neb., advised employers to keep track of all new hires with completed I-9s for whom there are no E-Verify queries due to the shutdown. She also recommended attaching a memo in a master E-Verify file tracking the days that the program was unavailable. "I've seen the discrepancy come up years later during an audit," she said.

"Once the system is back up, work with counsel on how much time employees have to resolve their TNCs," Peck said. "Someone receiving a TNC the day before the shutdown is a different case than somebody who had 10 days to resolve their TNC when the shutdown occurred. Those circumstances should be considered on a case-by-case basis."

Federal contractors with a federal acquisition regulation E-Verify clause should contact their government contracting officers to extend deadlines. "Federal contractors have a particular concern because nobody is supposed to be working who has not been verified through the system," Peck said. "People can be hired, but whether they are allowed to work on the contract before being run through E-Verify is a critical consideration that should be discussed with counsel."

Prepare for the Resumption of Service

Miller said employers should monitor the shutdown. "When it is over, log in to the system and see what instructions there are for creating and submitting queries," she advised. "There is an obligation to create those queries if you are enrolled in the program, even if enrolled voluntarily."

The backlog created as a result of the shutdown might have a significant impact on employers that process many E-Verify cases and specifically on the HR staff and other team members in charge of the process.

"Not all employers will be able to push all their cases through at once when the shutdown ends," Miller said. "If everyone did that, the system would crash. DHS will provide instructions on how to submit queries. Employers will be asked why the query is being submitted after the required three days. In the past, 'Government Shutdown' was one of the options in the drop-down menu."

Peck reminded employers that the loss of E-Verify does not mean there is a prohibition against hiring. "Companies should continue to hire as they need," she said.

SOURCE: Maurer, R. (3 January 2019) "E-Verify Is Down. What Do Employers Do Now?" (Web Blog Post). Retrieved from https://www.shrm.org/ResourcesAndTools/hr-topics/talent-acquisition/Pages/EVerify-Outage-What-Do-Employers-HR-Do.aspx


Call today, work tomorrow: The future of hiring?

A recent article from the Wall Street Journal states that more and more employees are being hired without a formal face-to-face interview. Continue reading to learn more about the future of hiring.


You just called a prospective candidate with a job offer, and they accepted. Pretty standard procedure — except you won’t meet the new hire until their first day of work.

In a hot job market, more workers are being hired without ever doing a formal face-to-face interview, according to a recent article in the Wall Street Journal. Hiring agencies and HR professionals are hearing more and more about hiring sight unseen, and the reviews are mixed. Agencies say it’s a fast and more efficient way to hire, while some HR professionals argue there’s no substitute for human interaction.

“We basically advertised jobs as call today, work tomorrow,” says Tim Gates, senior regional vice president of Adecco Staffing, which recently filled 15 openings without a formal in-person interview. “It makes it convenient for everybody involved.”

Adecco Staffing uses a digital hiring platform to prescreen candidates before setting up phone interviews. Applicants who ace the 20-minute phone conversation will likely be placed at a job site contracting Adecco. Gates says the practice gives his staffing agency a competitive edge by hiring people before they accept another position. He also believes this fast, straightforward approach is more attractive to job seekers seeking immediate employment.

Adecco hires sight unseen for entry level, manufacturing and specialized positions — like graphic design. They’re not alone. Susan Trettner, founder and director of direct hire placement firm Talent Direct 360, works with industries across the board but often hires workers for engineering, IT, HR, sales and marketing roles. Trettner says hiring without meeting a candidate is becoming more commonplace, especially for retail and e-commerce employers who have to hire large numbers of workers.

“Making a hiring determination over the phone is acceptable, and I think a lot of companies are doing that,” she says.

During the holidays, for example, retailers may not have the time to interview hundreds of candidates for a position, Trettner says. But, she adds, many companies that hire employees without meeting in person often have a “game plan” for onboarding that gets workers quickly up to speed on what they will be doing on the job. Making the hiring process more efficient is better for everyone, she says.

“It all comes down to filling the positions so they can remain productive,” she says.

Trettner says she would consider hiring workers without meeting them, but at the end of the day, it’s up to the employer client. If a client, for example, needs 300 new workers in a short period of time, Trettner says she would suggest they consider expediting the hiring process a bit to help save money and time.

“I open them up to anything I think is efficient,” she adds.

Some organizations would rather take extra time choosing candidates. Kathleen Sheridan, associate director of global staffing for Harvard Business Publishing, says she knows from 20 years of experience that phone interviews can’t tell you everything about a person. She once sat down with three candidates for a sales position; they all performed well during a phone interview, but completely fumbled while answering questions during a sit-down meeting. None of them were hired, Sheridan said.

“You can come across as a completely different person over the phone,” Sheridan says. “As cumbersome as interview process can be, the value of bringing people in and allowing them to see you is worth it.”

As someone who works with people on a daily basis, Sheridan says she would be distrustful of any job offer from someone she’s never met. She says higher-level executives at Harvard Business Publishing will travel out of the country to meet with prospective hires.

“A decision to join a company is emotional as well as very practical. I think you need to give people a chance to check their emotional response and get a feel for the culture and vibe,” Sheridan says. “I would ask myself, ‘what is it about your organization that you would deny me the opportunity to meet the people who are in the headquarters of this company that I’m going to represent?’”

Peg Buchenroth, HR director of employment agency Addison Group, says most of her clients request in-person interviews for job placements in the IT, engineering, healthcare and finance accounting industries. She says it’s unlikely to change.

“It’s maybe more common in the seasonal retail industry for the holiday season. For our types of positions, there’s no reason not to interview when we have the ability to do Skype interviews,” Buchenroth says.

SOURCE: Webster, K. (5 December 2018) "Call today, work tomorrow: The future of hiring?" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/call-today-work-tomorrow-the-future-of-hiring?brief=00000152-14a7-d1cc-a5fa-7cffccf00000


New resource offers guidance on digital tools for diabetes management

The market for digital diabetes management tools is continuing to mature. Read this blog post for the Northeast Business Group on Health’s updated guide on diabetes management tools.


The Northeast Business Group on Health has updated its “Digital Tools and Solutions for Diabetes: An Employer’s Guide,” to include both enhanced and new solutions—and promising future innovations—to help employers help their workers better manage their diabetes, lower costs and ultimately save more lives.

“Employers are well aware of the costs associated with diabetes in their employee and dependent populations—they continue to indicate this is a top concern and are increasingly aware of the links between diabetes and other chronic and debilitating health conditions, including cardiovascular disease,” says Candice Sherman, CEO of NEBGH.

The market for digital diabetes prevention and management solutions continues to mature since the group published its first guide in 2016, Sherman says. The updated guide provides a detailed checklist of the features and functionalities of the digital tools available now to manage diabetes, as well as information on several unique and innovative digital diabetes solutions that are being targeted to employers but were not part of NEBGH’s research, including Proteus Discover, BlueLoop and do-it-yourself programs.

“Proteus Discover is comprised of ingestible sensors, a small wearable sensor patch, an application on a mobile device and a provider portal,” the guide cites the provider. “Once activated, Proteus Discover unlocks never-before-seen insight into patient health patterns and medication treatment effectiveness, leading to more informed healthcare decisions for everyone involved.”

“BlueLoop is the one and only tool that allows kids and their caregivers to log and share diabetes information—both online and with the app—in real time, via instant e-mail and text message, giving peace of mind to parents,more class time for students and fewer phone calls and paper logs for school nurses,” the provider tells NEBGH. “Online, parents can share real-time BG logs with their clinicians, who can see logs (in the format they prefer), current dosages and reports, all in one place.”

The guide also hints at promising future innovations:

“Technology is constantly evolving: by connecting sensors, wearables and apps, it is increasingly possible to pool and leverage data in innovative ways to provide timely interventions so that people with diabetes can be truly independent and effectively self-manage their care,” the authors write.

The guide lists a hypothetical scenario: A person with diabetes enters a restaurant where a GPS sensor identifies the location, reviews the menu and proposes the best choices based on caloric and carbohydrate content. The technology also proposes and delivers a rapidly acting insulin bolus dose based on the person’s exercise level that day and prior experiences when eating similar meals.

Also included are key questions for employers considering implementing digital diabetes tools or solutions, including:

  • What does the company want to achieve with a digital tool?
  • How much is the company willing to pay?
  • How will success be measured?
  • How will digital solutions and tools be marketed to employees and their families?
  • What privacy issues need to be addressed when tools or solutions are implemented?

“Digital health tools hold the promise of improved health outcomes and reduced health care expenses through improved engagement, better collaboration and sustained behavior change,” says Mark Cunningham-Hill, NEBGH’s medical director. “However, digital diabetes solutions are not a panacea. Employers will need to address several obstacles such as the difficulty of recruitment and enrollment, lack of sustained employee engagement and the cost of deployment of digital solutions. This can be accomplished through careful planning and learning from other employers that have successfully implemented these tools.”

SOURCE: Kuehner-Hebert, K. (4 December 2018) "New resource offers guidance on digital tools for diabetes management" (Web Blog Post). Retrieved from https://www.benefitspro.com/2018/12/04/new-resource-digital-tools-for-diabetes-management/


Association Health Plans Meet the 2018 Form M-1

The Employee Benefits Security Administration (EBSA) recently released the 2018 version of the Form M-1. Read this blog post for more information about the new Form M-1.


The Employee Benefits Security Administration (EBSA) is continuing to do what it can to help bring the new class of association health plans (AHPs) to life.

EBSA, an arm of the U.S. Department of Labor, unveiled the 2018 version of the Form M-1 Monday.

Administrators of multiple employer welfare arrangements (MEWAs) that provide medical benefits use Form M-1 to report on the MEWAs’ operations to the DOL.

The administration of President Donald Trump completed work on major new AHP regulations in June. The administration is hoping small employers will use the new AHPs to shield themselves from some state and federal mandates and to get a chance to benefit from being part of a large coverage buyer.

Any AHPs out there, including any AHPs formed under the new regulations, will need to file the 2018 Form M-1 with the Labor Department, EBSA said Monday.

An AHP, or other MEWA, can use Form M-1 both to register a new plan and to file the annual report for an in-force plan.

The 2018 annual report for an AHP or other MEWA in operation now will be due March 1, 2019.

If agents, brokers, benefit plan administrators or other financial professionals are trying to start AHPs, they are supposed to use Form M-1 to register the AHPs at least 30 days before engaging in any AHP activity.

“Such activities include, but are not limited to, marketing, soliciting, providing, or offering to provide medical care benefits to employers or employees who may participate in the AHP,” EBSA officials said in the form release announcement.

Resources

Links to AHP information, including information about the 2018 Form M-1, are available here.

SOURCE: Bell, A. (4 December 2018) "Association Health Plans Meet the 2018 Form M-1" (Web Blog Post). Retrieved from https://www.thinkadvisor.com/2018/12/04/association-health-plans-meet-the-2018-form-m-1/


Poor hiring practices costing employers valuable talent

A survey by CareerBuilder and SilkRoad discovered that 68 percent of employees believe that their experience as a job candidate reflects how a company treats their employees. Read this blog post to learn more.


A growing number of employers say they find it hard to land good talent — but their own complicated or outdated hiring process may be partly to blame.

Job candidates today have higher expectations for communication, technology and onboarding during their job-search process, according to a new survey from job site CareerBuilder and onboarding tech provider SilkRoad. In fact, 68% of employees believe their experience as a job candidate reflects how the company treats its people.

Dissatisfaction with the process can begin as early as step one: Close to half of prospective workers (46%) are only willing to spend up to 15 minutes before giving up on an application, according to the report.

Not only is time of the essence, but the application experience is paramount, too. While potential workers won’t discount a company entirely for not having a mobile application option, employees are searching for jobs on their mobile devices more than ever before.

The fight for talent is only going to become more intense, and employers need to deliver on job seekers’ continuously evolving expectations to attract the best candidates, says CareerBuilder CEO Irina Novoselsky. “This starts with streamlining the entire hiring process, from the first candidate engagement to new-hire onboarding, which can be achieved through technological innovation and a more intuitive, mobile-friendly experience.”

A consistent dialogue remains another big must-have for candidates. Expectations among applicants are changing for when and how they hear from a prospective employer, the study found. Once they’ve applied, job seekers want more — not less — communication.

Many applicants cite a lack of acknowledgment or receipt notification from an employer for a submitted application as a top frustration of the job search. Additionally, 76% of job seekers say they expect to receive a personalized email from an employer acknowledging they received the application. This percentage decreases steadily as the age of the job seeker increases, but it’s consistently the top method of communication expected.

Other top notification methods include phone calls (36%) and text messages (18%).

Regardless of the type of communication, a majority of applicants want — and expect — employers to keep them updated throughout the process when they apply for a job. Candidates want a clear timeline for the hiring process and will begin to discount a company if they are left in the dark. When applying to a job, 55% of employees are willing to wait less than two weeks at the most to hear back from an employer before they give up and move on.

And employers shouldn’t end the engagement once an offer is made, the survey results suggest, because with 51% of potential candidates continuing to look for new opportunities after being extended an offer, the use of personalized, ongoing communication through the onboarding process will remain key.

When nearly one in 10 employees have left a company because of a poor onboarding experience, it’s important to understand the full scope of onboarding that is expected by today’s employees, according to the survey. Successful onboarding for a new hire is critical for their long-term vision of culture and career potential at the new company. However, a focus on the mission and growth factors of the company can’t neglect seemingly basic onboarding elements for the employee’s day-to-day experience and overall integration into operations.

“Technology is playing an increasingly critical role in enabling touchpoints along the recruitment and new-hire journey to facilitate human interactions,” says Robert Dvorak, CEO of SilkRoad. “We realize the customer’s journey doesn't end with a purchase, nor does the employee’s end with an offer. By using technology throughout the entire employment journey, employers can intentionally onboard candidates and employees, keeping them engaged at key points over time.”

SOURCE: Otto, N. (28 November 2018) "Poor hiring practices costing employers valuable talent" (Web Blog Post). Retrieved from: https://www.benefitnews.com/news/poor-hiring-practices-costing-employers-valuable-talent


2019: A Look Forward

A number of significant changes to group health plans have been made since the Affordable Care Act (ACA) was enacted in 2010. Many of these changes became effective in 2014 and 2015 but certain changes to a few ACA requirements take effect in 2019.

 Changes for 2019 

  1. Cost-sharing Limits – Non-grandfathered plans are subject to limitations on cost sharing for essential health benefits (EHB). The annual limits on cost sharing for EHB are $7,900 for self-only coverage and $15,800 for family coverage, effective January 1, 2019.
    • Health plans with more than one service provider can divide maximums between EBH as long as the combined amount does not exceed the out-of-pocket maximum limit for the year.
    • Beginning in 2016, each individual – regardless of the coverage the individual is enrolled – is subject to the self-only annual limit on cost sharing.
    • The ACA’s annual cost-sharing limits are higher than high deductible health plans (HDHPs) out-of-pocket maximums. For plans to qualify as an HDHP, the plan must comply with HDHP’s lower out-of-pocket maximums. The HDHP out-of-pocket maximum for 2019 is $6,750 for self-only coverage and $13,500 for family coverage.
  2. Coverage Affordability Percentages – If an employee’s required contribution does not exceed 9.5 percent of their household income for the taxable year (adjusted each year), then the coverage is considered affordable. The adjusted percentage for 2019 is 9.86 percent.
  3. Reporting of Coverage – Returns for health plan coverage offered or provided in 2018 are due in early 2019. For 2018, returns must be filed by February 28, 2019, or April 1, 2019 (if electronically filed). Individual statements must be provided by January 31, 2019.
    • ALEs are required to report information to the IRS and their eligible employees regarding their employer-sponsored health coverage. This requirement is found in Section 6056. Reporting entities will generally file Forms 1094-B and 1095-B under this section.
    • Every health insurance issuer, self-insured health plan sponsor, government agency that provides government-sponsored health insurance, and any other entity that provides MEC is required to finalize an annual return with the IRS, reporting information for each individual who is enrolled. This requirement is found in Section 6055. Reporting entities will generally file Forms 1094-C and 1095-C under this section.
    • ALEs that provide self-funded plans must comply with both reporting requirements. Reporting entities will file using a combined reporting method on Forms 1094-C and 1095-C.
    • Forms Used for Reporting – Reporting entities must file the following with the IRS:
      1. A separate statement for each individual enrolled
      2. A transmittal form for all returns filed for a given calendar year.
    • Electronic Reporting – Any reporting entity that is required to file 250 or more returns in either section must file electronically on the ACA Information Returns (AIR) Program. Reporting entities that file less than 250 returns can file in paper form or electronically on the ACA Information Returns (AIR) Program.
    • Penalties – Entities that fail to comply with the reporting requirements are subject to general reporting penalties for failure to file correct information returns and failure to furnish correct payee statements. Penalty amounts for failure to comply with the reporting requirements in 2019 are listed below:
Penalty Type Per Violation Annual Maximum Annual Maximum for Employers with up to $5 million in Gross Receipts
General $270 $3,275,500 $1,091,500
Corrected within 30 days $50 $545,500 $191,000
Corrected after 30 days but before August 1 $100 $1,637,500 $545,500
Intentional Disregard $540* None N/A

**Intentional disregard penalties are equal to the greater of either the listed penalty amount or 10 percent of the aggregate amount of the items required to be reported correctly.

Expected Changes

  1. Health FSA Contributions – Effective January 1, 2018, health FSA salary contributions were limited to $2,650. The IRS usually announces limit adjustments at the end of each year. This limit does not apply to employer contributions or limit contributions under other employer-provided coverage.
  2. Employer Shared Responsibility Regulations – The dollar amount for calculating Employer Shared Responsibility 2 penalties is adjusted for each calendar year. Applicable large employers (ALEs) must offer affordable, minimum value (MV) healthcare coverage to full-time employees and dependent children or pay a penalty. If one or more full-time employees of an ALE receive a subsidy for purchasing healthcare coverage through an Exchange, the ALE is subject to penalties.
    • Applicable Large Employer Status – ALEs are employers who employ 50 or more full-time employees on business days during the prior calendar year.
    • Offering Coverage to Full-time Employees – ALEs must determine which employees are full-time. A full-time employee is defined as an employee who worked, on average, at least 30 hours per week or 130 hours in a calendar month. There are two methods for determining full-time employee status:
      1. Monthly Measurement Method – Full-time employees are identified based on a month-to-month analysis of the hours they worked.
      2. Look-Back Measurement Method – This method is based on whether employees are ongoing or new, and whether they work full time or variable, seasonal or part-time. This method involves three different periods:
        • Measurement period – for county hours of service
        • Administration period – for enrollment and disenrollment of eligible and ineligible employees
        • Stability period – when coverage is provided based on an employee’s average hours worked.
      3. Applicable Penalties – ALEs are liable for penalties if one or more full-time employees receive subsidies for purchasing healthcare coverage through an Exchange. One of two penalties may apply depending on the circumstances:
        • 4980H(a) penalty – Penalty for not offering coverage to all full-time employees and their dependents. This penalty does not apply if the ALE intends to cover all eligible employees. ALEs must offer at least 95 percent of their eligible employees’ health care coverage. Monthly penalties are determined by this equation:
          1. ALE’s number of full-time employees (minus 30) X 1/12 of $2,000 (as adjusted), for any applicable month
          2. The $2,000amount is adjusted for the calendar year after 2014:
          3. $2,080 – 2015; $2,160 – 2016; $2,260 – 2017; $2,320 – 2018
        • 4980H(b) penalty – penalty for offering coverage – ALEs are subject to penalties even if they offer coverage to eligible employees if one or more full-time employees obtain subsidies through an Exchange because:
          1. The ALE didn’t offer all eligible employees coverage
          2. The coverage offered is unaffordable or does not provide minimum value.
          3. Monthly penalties are determined by this equation: 1/12 of $3,000 (as adjusted) for any applicable month
            1. $3,120 – 2015; $3,240 – 2016; $3,390 – 2017; $3,480 – 2018

Contact one of our advisors for assistance or if you have any questions about compliance in the New Year.

SOURCES: www.dol.gov, www. HHS.gov, https://www.federalregister.gov/documents/2018/04/17/2018-07355/patient-protectionand-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2019, https://www.irs.gov/e-fileproviders/air/affordable-care-act-information-return-air-program


Raspberry Mustard Ham with Saxon

Happy Holidays! In celebration of the holidays, the Saxon crew has decided to share one of our favorite holiday recipes for this month’s Fresh Brew! We hope you all have a safe and happy holiday season! 

Christmas Ham with Raspberry Mustard

Ingredients

  • 1 cup raspberry preserves
  • 1/2 cup Dijon mustard
  • 1 fully cooked bone-in ham (18 to 20 pounds)

Directions

  1. Preheat the oven to 325 degrees F. Mix together the preserves and mustard in a small bowl and set aside.
  2. Score the surface of the ham in a diamond pattern, about 1/8 inch deep. Bake according to the package instructions, 2 1/2 hours or longer. About 30 minutes before the cooking time is up, remove the ham from the oven and brush the glaze onto it. Cook until it’s nice and glossy. Repeat with another layer of glaze if desired.
  3. Serve the remaining glaze in a dish alongside the ham.

This recipe was provided by Food Network. If you’d like to visit the original source, please click here.

**Holiday Hours

  • Our office will close at 12 p.m. on Monday, December 24 and will be closed on Tuesday, December 25.
  • Our office will close at 12 p.m. on New Year’s Eve, Monday, December 31 and will be closed on New Year’s Day, Tuesday, January 1.

We wish you a happy holiday season filled with family and friends!

Give It A Try & Share It!


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