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Legal Alert: Senate Republicans Release Healthcare Bill; Largely Mirroring House Bill but with Some Key Differences

On Thursday, June 22, 2017, Senate Majority Leader Mitch McConnell of Kentucky released a 142-page healthcare “Discussion Draft” of legislation, called the Better Care Reconciliation Act of 2017 (BCRA), which is the Senate version of the Affordable Care Act (ACA) “repeal-and-replace” legislation American Health Care Act (AHCA) passed by the U.S. House of Representatives last month.  An updated “Discussion Draft” of the BRCA was released on June 26, 2017.  A summary of the updated June 26 draft of the BCRA by the U.S. Senate Committee on the Budget is available here and a section-by-section summary of the June 26th version is available here.

The major substantive change in the updated Discussion Draft released on June 26 was to add a new Section 206, beginning in 2019, that would subject an individual who has a break in continuous “creditable coverage” for 63 days or more in the prior year to a six-month waiting period (in the individual market) before coverage begins.  This provision is intended to provide an incentive for young and healthier individuals to maintain health insurance since the bill would eliminate the individual mandate.  The AHCA proposed imposing a 30% surcharge on those without continuous creditable coverage, but there were concerns over whether that provision could pass Senate parliamentary rules.

The unveiling of the Senate bill comes after weeks of drafting by a small group of Senate Republican leadership behind closed doors that has frustrated Democrats and left out many Republicans from the drafting process.  The Congressional Budget Office released its score of the legislation on June 26, 2017, finding that the updated Discussion Draft of the BCRA would leave 22 million more uninsured by 2026 than under the ACA (versus 23 […]

By |June 28th, 2017|Employee Benefits, Health Care Reform, Human Resources, Medical|Comments Off on Legal Alert: Senate Republicans Release Healthcare Bill; Largely Mirroring House Bill but with Some Key Differences

Legal Alert: REMINDER: PCORI Fees Due by July 31, 2017

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2017 deadline for paying fees that fund the Patient-Centered Outcomes Research Institute (PCORI).  As background, the PCORI was established as part of the Affordable Care Act (ACA) to conduct research to evaluate the effectiveness of medical treatments, procedures and strategies that treat, manage, diagnose or prevent illness or injury.  Under the ACA, most employer sponsors and insurers will be required to pay PCORI fees until 2019.

The amount of PCORI fees due by employer sponsors and insurers is based upon the number of covered lives under each “applicable self-insured health plan” and “specified health insurance policy” (as defined by regulations) and the plan or policy year end date.

  • For plan years that ended between January 1, 2016 and September 30, 2016, the fee is $2.17 per covered life and is due by July 31, 2017.
  • For plan years that ended between October 1, 2016 and December 31, 2016, the fee is $2.26 per covered life and is due by July 31, 2017.

For example, a plan year that ran from October 1, 2015 through September 30, 2016 will pay a fee of $2.17 per covered life.  Calendar year 2016 plans will pay a fee of $2.26 per covered life.

NOTE: The insurance carrier is responsible for paying the PCORI fee on behalf of a fully insured plan.  The employer is responsible for paying the fee on behalf of a self-insured plan, including an HRA.  In general, health FSAs are not subject to the PCORI fee.

Employers that sponsor self-insured group health plans must report and pay PCORI fees using IRS Form 720, Quarterly Federal Excise Tax Return.

Note […]

By |May 31st, 2017|Compliance, Employee Benefits, Employee Benefits Adviser, Employee Communications, Health Care Reform|Comments Off on Legal Alert: REMINDER: PCORI Fees Due by July 31, 2017

One Question Makes a Big Difference: Is your broker simply shopping your medical program, or utilizing actuarial analysis?

The real issue is how do you know if you are over paying for your medical plan? When we hear that companies are not using an actuary we ask another simply question: How do you know you are not overpaying? Where’s the analysis? We’ve yet to hear a convincing explanation. How can you or your broker possibly know, because they aren’t trained or qualified to interpret incurral factors, group specific trend and expected large claims versus actual as an actuary is, so they can’t know if there is an argument to be made. […]

By |August 26th, 2016|Employee Benefits, Employee Benefits Adviser|Comments Off on One Question Makes a Big Difference: Is your broker simply shopping your medical program, or utilizing actuarial analysis?

Legal Alert: DOL Proposes Changes to Annual Reporting for ERISA Plans

The U.S. Department of Labor (DOL) recently proposed revisions to Form 5500 (Annual Return/Report for Employee Benefit Plan), the related schedules, and the rules that govern the forms. In general, these changes would first apply for the 2019 plan year, although certain changes may be implemented earlier. These proposed revisions were published on July 21, 2016, and comments are being accepted for 75 days, through October 4.

The proposed revisions are intended to “modernize the financial statements and investment information filed about employee benefit plans; update the reporting requirements for service provider fee and expense information; enhance accessibility and usability […]

By |July 28th, 2016|Compliance, Employee Benefits, Human Resources, Legislation|Comments Off on Legal Alert: DOL Proposes Changes to Annual Reporting for ERISA Plans

How Your Company Can Benefit From an Executive Reimbursement Plan

Today’s companies are constantly struggling to attract and retain good talent. And, most companies are offering special perks, or benefits to help do this. But, what about something a little more enticing than a parking spot that’s close to the entry door? What about an executive reimbursement plan? An executive reimbursement plan offers select executives, or group of employees chosen by an employer, additional medical, dental or eye coverage to pay the left over portion […]

By |July 28th, 2016|Employee Benefits, Human Resources, Voluntary Benefits|Comments Off on How Your Company Can Benefit From an Executive Reimbursement Plan

Legal Alert: HHS Issues Final Rule on ACA Nondiscrimination Provisions (Section 1557)

The Department of Health and Human Services (HHS) published a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of, among other grounds, sex (including gender identity) in certain health programs and activities. Entities covered under the rule cannot deny, cancel, limit or refuse to issue health coverage; deny or limit a claim; or impose additional cost sharing on a protected individual.

The rule will require many group health plans and employers to cover health care services provided to transgender individuals and is expected to have broad implications for the provision of transgender- and gender transition-related medical treatment. The length to which the rule may apply to a particular plan or employer involves some analysis. However, it is clear that HHS intends to encourage coverage of health care services […]

By |July 22nd, 2016|Employee Benefits, Health Care Reform, Legislation, Medical|Comments Off on Legal Alert: HHS Issues Final Rule on ACA Nondiscrimination Provisions (Section 1557)

The Numbers Are In… And They’re Shocking!

We’ve successfully identified two types of brokers in the benefits industry and created a short video to explain things a little further. Once the video comes to an end you will be able to easily determine if your company is with the majority, or the minority. Making this determination could be exactly what you need to save money, and gain the extra support your HR Department has been hoping for.

So, who are you working with? […]

By |July 11th, 2016|Employee Benefits, Employee Benefits Adviser, Human Resources|Comments Off on The Numbers Are In… And They’re Shocking!

Legal Alert: ACA Reporting Update: AIR System Will Remain Up and Running After June 30th Deadline

While the deadline to electronically file Affordable Care Act (ACA) information returns with the IRS passed on June 30, 2016, the ACA Information Returns (AIR) system used to electronically file those returns will remain up and running.

On June 30th, the IRS noted the following on its AIR system home page:

  • The AIR system will continue to accept information returns filed after June 30, 2016. In addition, employers can still complete required system testing after June 30, 2016.
  • If a filing was rejected, the employer has 60 days to submit a replacement and have the rejected submission treated as timely filed.
  • When a filing is “accepted with errors,” employers may continue to submit corrections after June 30.
  • Employers that were unable to submit their returns by June 30 should still file their returns after the deadline. Employers that missed the deadline will generally not be assessed late filing penalties if the employer made legitimate efforts to register with the AIR system and to file its information returns, and it continues to make such efforts and completes the process as soon as possible.

When an employer’s filing is “accepted with errors” due to incorrect name/TIN combinations, it does not necessarily require resubmission; however, the employer should make a good faith attempt at validating the information. Any corrections should be made as soon as possible once the correct information becomes available.

Also, while there is no specific relief provided in the case of employers that fail to file returns by the deadline, relief may be available if the IRS determines that there was reasonable cause for the delay

Employers that did not file electronically and that missed the May 31, 2016, paper filing deadline should also complete the filing of their paper […]

By |July 8th, 2016|Compliance, Human Resources, Legislation|Comments Off on Legal Alert: ACA Reporting Update: AIR System Will Remain Up and Running After June 30th Deadline

Legal Alert: Marketplace Subsidy Notices: What Employers Need to Know

In late June, the U.S. Department of Health and Human Services (HHS) reportedly mailed out several hundred thousand notices to employers, dated June 21, 2016, informing them that one or more of their employees have been certified as eligible for a premium subsidy through a federal Health Insurance Marketplace. Employers in states with state-run Marketplaces may have received similar notices since 2015; however, HHS has just begun sending notices from the federal Marketplaces this June. A list of states and whether their Marketplace is state-based or federally-facilitated can be found here.

The notice informs the employer that the individual indicated that he or she worked for the employer and either: (i) didn’t have an offer of health care coverage from the employer; (ii) did have an offer of health care coverage, but it wasn’t affordable or did not provide minimum value; or (iii) was in a waiting period and unable to enroll in health care coverage.

This alert describes the appeal process and provides recommendations for employers who have received a notice and are considering whether to appeal.

Foremost, receipt of a Marketplace subsidy notification […]

By |July 6th, 2016|Compliance, Human Resources, Legislation|Comments Off on Legal Alert: Marketplace Subsidy Notices: What Employers Need to Know

Unique HR and Benefit Department Challenges for Law Firms

The Human Resource and Benefits departments of law firms face unique challenges when dealing with attorneys and staff, personnel issues, and hiring and retaining talent.  Because Broad Reach Benefits works closely with law firms of all sizes, we are familiar with the issues you face every day.  Some of the expected challenges HR and Benefits departments can keep in mind when working at a law firm include:

Reporting Structure
While attorneys must supervise the legal work conducted by paralegals and assistants, there is often a reporting structure within the legal support staff, as well as the need to report to HR for performance, administrative, and personnel issues. With so many levels and layers in the organization, consistency is key. It is important to have a handbook that everyone can reference and rely on and an engaged HR department that maintains professionalism and proactively avoids conflict. […]

By |June 22nd, 2016|Employee Benefits, Employee Benefits Adviser, Law Firms|Comments Off on Unique HR and Benefit Department Challenges for Law Firms