Study: Employer Sponsored Health Plans Generate 47% ROI

Study: Employer Sponsored Health Plans Generate 47% ROI

Health insurance is expensive, and we’ve all asked ourselves, “Is it really worth what I am paying?”. For employer-sponsored health insurance, the answer is a resounding YES it is. For every dollar employers spent on health insurance-related costs, they get back $1.47 according to a new study from Avalere Health. This figure in fact is expected to grow to 52% by 2026 from 47%.

The U.S. Chamber of Commerce commissioned the Avalere Health employer study that used publicly available data from the Bureau of Labor Statistics and the Congressional Budget Office to estimate the return on investment employer-sponsored health insurance provides employers with 100 or more employees.  Improved employee productivity, reduced direct medical costs, and tax benefits were the primary aspects that generated benefits for employer-sponsored health plans. Employers who offered employer-sponsored health coverage and wellness programs had healthier employees and spent less on direct medical costs, Avalare found.

The Numbers

Share of Benefits by Component as % of ROI for ESI

Employee productivity reflects the reductions in absenteeism and lost productivity after receiving employer-sponsored coverage. These productivity increases contributed an estimated $275.6 billion in employer benefits in 2022, or 53.3% of all benefits. By 2026, this is expected to rise to $346.6 billion or 55.9 percent of total ROI.

ROI of some of these key components includes $275.6 billion from improved productivity in 2022 and $346.6 billion in 2026, $101 billion from a reduction in direct medical costs in 2022 and $108 billion in 2026, and $119.2 billion or a 23% ROI from tax benefits in 2022 and $139.7 billion in 2026.

Employer-Sponsored Insurance(ESI) offerings can positively influence prospective employees’ decisions to join firms, reducing employer recruitment and vacancy costs. The study’s model assumes that 9% of individuals decide to accept a certain position based on ESI. The analysis estimates that firms with 100 or more employees derived $141M in employer benefits in 2022, growing to $167M in 2026.

Similarly, ESI positively affects the retention of employees. Avalere’s analysis estimates $20.3B in employer benefits from improved retention in 2022 and $24.3B in 2026.

Conclusion

The study finds that industries where firms generally made greater investments in ESI tended to result in larger ROI. Also, since costs associated with turnover and recruitment are positively associated with wages, Avalere estimates higher ROI in higher-wage industries. On the flip side of that same coin, lower ROI was associated with industries that typically have a lower investment in ESI and wellness programs, lower wages, and lower employee participation in ESI and wellness programs.

The full report including the methodology can be found here.

For more information on how Employer-Sponsored Insurance and a PEO can make difference for your small business please contact us at info@360peo.com or 855-667-4621.

 

Study: Employer-Sponsored Health Insurance Produces +47% ROI

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Webinar: How HDHP Can Set Employees Up for Financial Success

Webinar: How HDHP Can Set Employees Up for Financial Success

Workshops & Talks

Hands On Training with Samuel Kina, Ph.D. | Chief Analytics Officer | Picwell, Inc.

How High Deductible Health Plans Can Set Employees Up for Financial Success

Overview

A common fear among employees can be that High Deductible Health Plans (HDHPs) expose them to too much risk. However, this misconception misses the near-certain long-term losses that come with not choosing a HDHP that includes an HSA. What employees are often missing is a full knowledge of the long-term financial impacts and risks associated with enrolling in an HDHP paired with HSA savings strategy, compared to a more traditional, low deductible PPO option. Employer contributions to HSAs can also set employees up for financial success and retirement readiness.

More Info

Join this complimentary webcast to discover how HSA-eligible plans are better for employees in the long run and can help improve their financial health. Topics discussed will include:

  • The short term risks that scare employees away from an HSA plan

  • The long term benefits that make HSAs a no-brainer

  • Ways to overcome employees’ apprehension towards HSAs to get them to enroll and contribute

  • And more…

Date: Wednesday, June 15 2022

Time: 2:00 p.m. ET 

Cost: Complimentary

Day(s)

:

Hour(s)

:

Minute(s)

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Second(s)

Samuel Kina, Ph.D. | Chief Analytics Officer | Picwell, Inc.

 

Bio

Samuel Kina, Ph.D. is the Chief Analytics Officer at Picwell, Inc. where he has led the company’s work in economic and predictive modeling since 2014, shortly after the company was founded. He has a wide range of experience in health policy and economics in the public, private, and non-profit sectors. He has advised several state and private health insurance exchanges, and he has provided economic and strategic support to several pharmaceutical manufacturers, health insurance companies, regulatory agencies, and Congress in matters related to health policy, intellectual property, antitrust regulation and FDA regulation and drug approval. Sam has taught courses in statistics, economics, and health policy, and his research has focused on the economics of the health insurance and pharmaceutical industries.

Prior to joining Picwell, he held positions at the Analysis Group, Congressional Budget Office, and the Alliance for Health Reform. Sam has a BA in Public Policy Analysis and Economics from Pomona College and a Ph.D. in Health Policy and Economics from Harvard University.

REGISTER NOW! (Not able to attend? We recommend you STILL REGISTER – you will receive an email with how to access the recording of the event)

Contact

Phone

(855)-667-4621

Email

info@medicalsolutionscorp.com

Address

7495 Atlantic Ave 
Delray Beach, FL 33446

HSA 2023 Dollar Limits

HSA 2023 Dollar Limits

The IRS has released the 2023  Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

New HSA 2023 limits are as follows:

 

 

2023

2022

HSA Annual Contribution Limit
$3,850;  $7,750
$3,650 – Single; $7,300 – Family
HDHP Minimum Annual Deductible
$1,500;  $3,000
$1,400 – Single; $2,800 – Family
HDHP Out-of-Pocket Maximum
$7,500;  $15,000
$7,050 – Single; $14,100 – Family
Age 55+ Catch-Up Provision
$1,000;  $2,000
$1,000- Single; $2,000 – Husband/Wife

 

Age 55 Catch Up Contribution

As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of the year, you can contribute an additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute an additional $1,000. A savvy strategy for high-income earners is to invest the money in your HSA for the long haul. Once you’re 65, you can take out tax-free distributions to cover Medicare premiums. If you withdraw money at that point for non-medical uses, you pay the same tax as you would on withdrawals from a pretax 401(k). But you can also take money out tax-free to reimburse yourself for prior years’ out-of-pocket medical expenses if you have the old receipts.


COVId-19 Update: 

You can even use an HSA to save on a typical trip to the CVS. Thanks to a tax relief provision tucked in the last Covid-19 stimulus package, you can use the money you stash in an HSA or FSA (more on those later) for over-the-counter medications like Tylenol or Flonase as well as menstrual products like tampons and pads. That reverses Obamacare restrictions on OTC meds requiring a doctor’s prescription for them to be eligible for reimbursement.

 

HSA/HDHP Market Growth

HSA holders own the assets in the accounts and can build up substantial sums over time.  Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.

FSA Store

HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.

  • The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
  • 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
  •  14% of all workers in the private sector have access to a Health Savings Account acc. to the Bureau of Labor Statistics.
  • States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois, and Minnesota.

HSA Advantages:

  • Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
  • Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
  • Tax-Free Money allowed for non-traditional Medical coverage– As per IRS Publication 502, unused money can be used for dental, vision, Lasik eye surgery, acupuncture, yoga, infertility, etc.  Popular Examples
  • Portability – The funds belong to you, so you keep the funds if you change jobs or retire.

Our overall experience with HSAs has been positive when employer funding is at a minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money).  Traditional plans trend of higher copays and new in-network deductibles has also led to the popularity of an HSA.

Next Steps

Plan sponsors should update payroll and plan administration systems for the 2022 cost-of-living adjustments and should incorporate the new limits in relevant participant communications, such as open enrollment and communication materials, plan documents, and summary plan descriptions.

RESOURCE:

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right for you? Please contact our team at 360PEO (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for the latest news updates.

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Free Telehealth Restored Under HSA Until 2023

Free Telehealth Restored Under HSA Until 2023

Free Telehealth Restored Under HSA until 2023

Effective April 1, 2022, high-deductible health plans can once again offer first-dollar coverage for Telehealth and other remote services without making participants ineligible for health savings account (“HSA”) contributions.  The relief runs only through the end of 2022. This relief allows individuals with High Deductible Health Plans  (“HDHPs”) to receive free telehealth services prior to the satisfaction of their minimum deductible and remain eligible to make Health Savings Account (“HSA”) contributions.

Background

Individuals may contribute to an HSA if they are covered by a qualifying HDHP and do not have other disqualifying coverage. Generally, telehealth or other remote health care services are considered other health care coverage that, if provided before satisfaction of the required deductible, may be disqualifying for purposes of contributing to an HSA. 

The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) were signed into law on March 27, 2020. Among other things, the CARES Act offered temporary relief related to telehealth and other remote care services when offered with an HDHP and HSA. Specifically, for plan years beginning on or before December 31, 2021, telehealth and other remote care services could be offered before satisfaction of the deductible without jeopardizing an individual’s eligibility to contribute to an HSA.

Employer Action

Employers offering HDHPs with HSAs should consider whether to re-implement (or continue) free telehealth as part of a benefit offering. Employers with calendar year plans may 

have already re-introduced a cost associated with telehealth for HDHP/HSA participants once the CARES Act relief expired and should consider whether to waive those costs again given the temporary nature of this relief. Additionally,  employers with non-calendar year plans should consider the administrative and communication burdens that may be imposed by providing relief that may expire prior to the end of the current plan year. 

It is important that employers review these changes with their carriers, Third Party Administrators and telehealth vendors to understand their approach and communicate any changes with participants.

Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@360peo.com.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Why We Love PEO This Valentine’s Day

Why We Love PEO This Valentine’s Day

We already love Professional Employer Organization (PEO)– our clients do too.  Today we’re counting down our top 5 reasons why we love PEO:   Top 5 Reasons Why We Love PEO

1.National Capabilities:

It ensures your compliance with local and federal laws, even if your business has locations in different states. Access to a national provider healthcare plan, not single state carriers

2. Liability Protections:

Some liability moves to the PEO service instead of your company.

3. It saves you money on HR staff.

Being part of a PEO gives you a clear cut idea of what your costs are going to be year in and year out. The PEOs work tirelessly to keep their insurance renewals down, so their clients won’t leave. Every year they work with the insurance carriers to introduce new plans and ways to reduce the costs of insurance to their clients. This gives you the ability to forecast and know precisely what your costs will be.

4.  Technologies:

Online HR resources for self service issues  Ability for employees to make personal changes on their own, online. Ability to track PTO (paid-time off).

 5. One Vendor:

It streamlines HR tasks like payroll, taxes, employee benefits, worker’s compensation, 401K and HR administrative tasks.

Our PEO Quoting Tool ensures that we have first-hand insight as to what the small business owner needs to be successful. Click below for quote.

Health Insurers Cover Home COVID-19 Tests

Health Insurers Cover Home COVID-19 Tests

Starting January 15 at-home CIOVID-19 tests will be free of charge. This order was issued last week Biden-Harris Administration Requires Insurance Companies and Group Health Plans to Cover the Cost of At-Home COVID-19 Tests, Increasing Access to Free Tests.

Free At-Home COVID-19 Test available via USPS. On Jan. 18, every home in the United States can order up to four free COVID-19 tests. January 19, Americans will be able to order free at-home rapid COVID tests from the government at COVIDTests.gov.

The federal guidance requires commercial insurers and group health plans (both fully insured and self-insured) to reimburse consumers for the cost of Over-the-Counter (OTC) COVID-19 diagnostic tests, with or without an order or clinical assessment by a healthcare provider.

Types of COVID Tests:

  • Antigen tests, which test for an active infection by detecting specific virus proteins. Most at-home tests and “rapid tests” performed by healthcare providers fall in this category.
  • Molecular tests, which test for an active infection by amplifying genetic material from the virus. These are considered the “gold standard” for diagnosing COVID, as they are generally more accurate than antigen tests. The most familiar test from this category is the polymerase chain reaction (or PCR) test, which requires lab processing. 
  • Antibody tests, which are blood tests that determine if the body has had an immune response to the virus. These tests are not used for diagnosing an active infection.

How Will this work with your Insurer?

Consistent with the guidance Insurers will utilize existing member claims submission procedures to provide benefits without cost-share for OTC COVID-19 tests that members purchase, either online or through other retailers. In addition to the member demographic information that is normally filed with member-submitted claims, the members will be required to certify that the test was purchased for personal use and not for employment purposes.

Customers may receive reimbursement for up to 8 COVID-19 OTC tests per covered individual per calendar month without a health care provider prescription or individualized clinical assessment. For a family of four covered individuals, that equates to 32 tests per month.

Members with Empire Blue Cross, for example, will utilize A.I. apps such as Sydney App or online.  Separately, Insurers such as UnitedHealthcare will initially offer for at-home COVID-19 tests are Walmart Pharmacy and Rite Aid Pharmacy. When using Walmart or Rite-Aid there will be no up-front cost and you will not have to submit a form for reimbursement. Note, you may be required to go to the pharmacy counter to obtain the test kits at no cost.

Note, only tests that are FDA approved and sold by an authorized reseller are eligible for reimbursement. For updates, go to Approved COVID-19 Home Tests | NC COVID-19 (ncdhhs.gov).

Insurance Resources:

Aetna

CIGNA

Empire BlueCross / Anthem

Halthfirst

Horizon Healthcare NJ

Oxford/Unitedhealthcare

If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

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5 Tips to Staying Healthy During Flu Season

5 Tips to Staying Healthy During Flu Season

You can get ahead of cold and flu season by embracing a few habits that can help support a healthy immune system. 

Plus, boosting your natural immunity doesn’t have to be time-consuming or expensive. 

You may be doing some of these things already. If not, take baby steps to build new habits, because trying to do too much too soon may lead to frustration. 

What steps can you take to fit these five tips into your life?

1. Get a good night’s rest. 

Like stress, sleep deprivation can reduce the effectiveness of your immune system and lead to a longer recovery time if you do get sick. 

Practice good sleep habits like putting away your devices before bed and creating a wind-down routine to help you relax.

2. Watch your stress levels.

Stress can weaken your immune system, making it harder to fight off a cold or the flu. Try practicing stress-reduction techniques such as daily meditation or breathing exercises.

3. Keep your hands clean. 

Wash your hands often, especially when entering or leaving public places or touching surfaces. Cleaning your hands with soap and water for at least 20 seconds can be the best way to remove germs. When that’s not possible, use a hand sanitizer with at least 60% alcohol.

4. Stay active. 

Exercise can help alleviate stress and support your immune system — and physical activity doesn’t have to be intense to make a difference. To get started, you can try taking a daily walk or practicing gentle yoga poses.

5. Focus more on nutrition.

A healthy diet supports a healthy immune system. In addition to the supplements, you may already take, try to eat foods rich in vitamins and minerals, such as:

  • Citrus fruits
  • Spinach
  • Green tea
  • Shellfish

 

Cleveland Clinic:  We’re now several months into the coronavirus pandemic, and we’re also fast-approaching peak season for yet another viral illness: influenza. Infectious disease specialist Kristin Englund, MD, explains the differences between COVID-19 and the flu, and shares steps we can all take to help us stay healthy this flu season. 

 

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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OSHA Issued COVID-19 Vaccination (ETS)

OSHA Issued COVID-19 Vaccination (ETS)

sCMS and OSHA released interim final rules this week detailing the implementation of national vaccine requirements established by President Biden’s executive order in September.Yesterday, the Department of Labor released an unpublished version of the OSHA Emergency Temporary Standard (ETS).

 The ETS is effective immediately and will cover 2/3rds of private employers. The OSHA ETS puts into effect the Biden Executive Order mandating all private employers with 100 or more employees ensure their employees are vaccinated against COVID-19, or submit negative weekly tests.

KEY Summary:

Covered Employers

    • Private employers with 100 or more employees enterprise-wide (across US locations) at the time these rules become effective
      • Independent contractors not included
      • Special franchisee, construction and staffing agency rules
      • Companies who grow will move into the covered group
    • State/local governments, including schools
    • Only state/local ordinances/laws that are not conflicting will have effect (i.e., if the state law prohibits vaccine mandates, OSHA ETS will supersede state law. OSHA ETS will be mandated.)
      • States with state OSHA plans may adopt these federal rules or similar rules. Some states are threatened with removal of state plan authority for failure to comply with laws as stringent as federal (e.g., UT & AZ)

Compliance Deadline

    • Within 30 days of publication (December 5)
    • Testing requirements within 60 days (January 4)

Mandate

    • Determine vaccination status of each employee
      • Obtain acceptable proof – 
      • Maintain records/roster
    • Unvaccinated must test negative weekly if worker in workplace at least once a week or within 7 days before returning to work if worker is away from workplace a week or longer
      • Must wear face covering indoors or in occupied vehicle for work
      • Employer not required to pay for testing unless required by law or collective bargaining agreement
      • Employer not required to pay for face coverings
    • Notice
      • Employee must promptly notify of positive COVID test or receive diagnosis
        • Employer must remove employee from workplace, regardless of vaccination status
        • May not return to work until meeting criteria
    • Must provide paid time off for vaccination and recovery from side effects

OSHA is offering robust compliance assistance to help businesses implement the standard, including a webinarfrequently asked questions and other compliance materials.  

Conclusion

In conclusion, employers subject to the ETS must determine whether they will take a vaccine-only or combined vaccine and testing/face covering approach to compliance and must develop the required written policies and communicate those policies to employees so they have ample time to receive their COVID-19 vaccines.  Employers should work with legal counsel to develop their written policies and to address any reasonable accommodation requests received by employees.

If needing employment law assistance in implementing these new rules, contact your World Insurance Associates representative so that they can connect you a Jackson Lewis P.C. council in order to receive the WIA arrangement. For our PEO clients, please speak with in-house council and HR. 

The information provided in this alert is not, is not intended to be, and shall not be construed to be, either the provision of legal advice or an offer to provide legal services, nor does it necessarily reflect the opinions of the agency, our lawyers, or our clients.  This is not legal advice. Rather, the content is intended as a general overview of the subject matter covered.  

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Montefiore and Oxford Reach Agreement

Montefiore and Oxford Reach Agreement

​Good news Bronx/Westchester.  Oxford and Montefiore Health System announced moments ago that they have reached an agreement effective December 1, 2021 for UnitedHealthcare and Oxford employer-sponsored plans, as well as UnitedHealthcare’s Medicare Dual Special Needs Plan.  

This resolves a split since Jan 1, 2021 which affected a significant percentage of local residents as both companies have a critical size of the market. Westchester and Bronx populations total nearly 2.5 million people. While this contract is resolved with titanic and a few Hospital Systems and Insurers left in the market we expect to see this trend to continue.

See below the official press release. 

 

UnitedHealthcare and Montefiore Health System Renew Relationship

UnitedHealthcare and Montefiore Health System have reached a multi-year agreement that restores access to Montefiore’s hospitals and physicians for people enrolled in UnitedHealthcare and Oxford employer-sponsored plans as well as UnitedHealthcare’s Medicare Dual Special Needs Plan, effective Dec. 1, 2021.

We recognize that the care Montefiore provides is not only important but also personal to our members and we also know the negotiations process may have been difficult for them. Our top priority throughout this process was ensuring the people and employers we’re honored to serve in New York have access to quality, more affordable health care, and this new agreement helps accomplish that goal.

We thank our members and customers for their support and patience throughout this process. We are honored to continue supporting the more than 3.7 million individuals across New York who depend on us for access to quality and affordable health care.

Montefiore Hospitals & Health System

Facility NameCounty
Montefiore Hospital (Moses Campus)Bronx
Children’s Hospital at MontefioreBronx
Garnet Health MedJack D. Weiler Hospital (Einstein Campus)ical CenterBronx
Montefiore Wakefield Hospital (Wakefield Campus)Bronx
Burke Rehabilitation HospitalWestchester
Montefiore Mount Vernon HospitalWestchester
Montefiore New Rochelle HospitalWestchester
Montefiore Nyack HospitalRockland
Montefiore St Luke’s Cornwall HospitalOrange
White Plains HospitalBronx
Montefiore Hutchinson CampusBronx
Montefiore Medical GroupWestchester
Montefiore Medical Specialists of WestchesterWestchester

 

Neighboring Hospitals

Facility NameCounty
Bon Secours Community Hospital
BronxCare Hospital Center
Garnet Health Medical Center
Good Samaritan Hospital of Suffern
New York Presbyterian Hudson Valley Hospital
New York Presbyterian Lawrence Hospital
NYC Health + Hospitals Jacobi
NYC Health + Hospitals Lincoln
NYC Health + Hospitals North Central Bronx
St. Anthony Community Hospital
St. Barnabas Hospital
St. John’s Riverside Hospital
Westchester Medical Center
Orange
Bronx
Orange
Rockland
Westchester
Westchester
Bronx
Bronx
Bronx
Orange
Bronx
Westchester
Westchester

Leading Health Insurers 

2021 Empire Blue Cross Blue Shield
2021 EmblemHealth 
2021 Healthfirst Plans
2021 New Oscar Circle Plus

 

Resources:

KeepMontefiore.Org

https://www.uhc.com/montefiore

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Medicare 2022 Open Enrollment

Medicare 2022 Open Enrollment

Medicare 2022 Open Enrollment

Full Information

 

Medicare Supplemental Plan F phased out for newly Medicare eligible? With the new 2022 open enrollment changes, it’s time to get the facts. Considering making changes to your coverage this fall or just want to learn more about this enrollment period?

During the Medicare open enrollment period – which runs from October 15 through December 7 – you can make a variety of changes (none of which involve medical underwriting):

  • Switch from Medicare Advantage to Original Medicare or vice versa.
  • Switch from one Medicare Advantage plan to another.
  • Switch from one Part D prescription plan to another.
  • Join a Medicare Part D plan.
  • Drop your Part D coverage altogether.

1. Medicare Supplement Plans F and C are still available

While the Centers for Medicare and Medicaid (CMS) will no longer allow newly eligible Medicare beneficiaries to enroll in Medigap plans F and C, these plans aren’t disappearing completely. If you become eligible for Medicare before January 1, 2021 (and that’s everyone who can use the 2021 fall Medicare Open Enrollment Period), you can apply for these plans now and in the future—even if you aren’t already enrolled in Medigap.

If you become eligible for Medicare on or after January 1, 2020, you won’t be able to enroll in Plans F or C now or in the future.

 

2. The Part D ‘donut hole’ will close

In 2022, you’ll enter the donut hole when your spending + your plan’s spending reaches $4,430. And you leave the donut hole — and enter the catastrophic coverage level — when your spending + manufacturer discounts reach $7,050. Both of these amounts are higher than they were in 2021, and generally increase each year.  Learn more about Part D.

3. Changes in Medicare Advantage and Part D plans

Every year, insurers make small changes to their Medicare Advantage and Part D plans. Typically, these changes include changes in premiums, deductibles, and other costs. Keep in mind, the Medicare program may not finalize these changes until right before fall Open Enrollment.

See the latest Medicare premiums and deductibles now or come back in October. We’ll share finalized changes as soon as they become available.

Refresh your general Medicare knowledge

While the Medicare program changes a bit each year, much of it stays the same. It never hurts to refresh your Medicare knowledge. We recommend starting with an Overview of Medicare. This Medicare Glossary could come in handy, too, as you read through insurance documents.  See 

CMS Releases 2022 Projected Medicare Part D Average Premium

 

4. Medicare B Increases 

Medicare Part B premiums increased this year by about 2.7% or $4 per month and high-income surcharges also rose modestly in 2021. For 2022 the Standard Part B premiums are projected to be $158.50/month from $148.50/month in 2021 or a 6.7% increase.

The wealthiest senior couples will be paying more than $12,000 a year in Medicare Part B premiums. Part B (the base and the surcharge) covers doctors’ and outpatient services. Medicare Part B Income-Related Monthly Adjustment Amounts.

5. Part B deductible also increased for 2021, and will increase again in 2022

Medicare B also has a deductible, which increased to $203 in 2021, up from $198 in 2020. For 2022, the Part B deductible is projected to be $217. The Medicare Part B deductible only has to be paid once per year, unlike the Part A deductible, which has to be paid once per benefit period.

 

 Do you have to renew your plan?

If you’re happy with your Medicare coverage, there’s no need to do anything during Medicare Open Enrollment. Provided your current plan is available next year, your coverage will auto-renew.

Although you could let Open Enrollment pass right on by without having to lift a finger, we recommend doing two things this fall to optimize your Medicare coverage.

1. Read Medicare Mailers

If your plan is discontinued next year, you’ll receive a notice in the mail. If you miss this notice and fail to enroll in other coverage, you could lose your coverage.

If your plan continues in the following year, your insurer will send you an Annual Notice of Change (ANOC). Look over your ANOC carefully to make sure your plan will still meet your needs next year. If not, its time to consider other options.

 

No matter how you feel about your current plan, it’s usually a good idea to do a little shopping around during Open Enrollment. Since plans and premiums change annually, options that fit your situation even better than your current coverage could pop up. But if you don’t check, you’ll never know.

Know These Dates

OCT 15 - DEC 7

OPEN ENROLLMENT PERIOD for Medicare Advanatage and Medicare Part D Prescription Drug coverage.  All individuals with Medicare can change their Medicare health plan and prescription drug coevrage for the next year. 

JAN 1 - FEB 14

MEDICARE ADVANTAGE DISENROLLMENT PERIOD. Those with MA plans (Part C) can leave the plan and switch to original Medicare.

JAN 1 - DEC 31

MEDICARE SUPPLEMENT (Medigap) plans can be purchaded year-round but may require answering health questions to determine eligibility.  

Total Number of Million Medicare Beneficiaries. Source: Kaiser Family Foundation

2020

2018

2017

2015

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Must Know Cyber Stats For 2021

Must Know Cyber Stats For 2021

Cybersecurity Awareness Month is intended to raise employee awareness in every way possible.

It’s never been more important for cybersecurity to be top of mind for all of us. We are all connected to the internet both professionally and personally, therefore, we are all exposed to the bad guys. To that end,  it’s important that we know how to prevent cybersecurity attacks and what it means to do our part and be Cyber Smart.

Stats

  • The U.S government allocated an estimated $18.78 billion for cybersecurity spending in 2021.
  • Damage related to cybercrime is projected to hit $10.5 trillion annually by 2025.
  • 64% of Americans have never checked to see if they were personally affected by a data breach.
  • 16% of healthcare providers reporting having “fully functional” security programs.
  • In April 2020, Google blocked 18 million daily malware and phishing emails related to COVID.
  • 89% of healthcare organizations had patient data lost or stolen in the past two years.
  • Google has registered 2,145,013 phishing sites as of January 17, 2021.  This is up from 1,690,000 on January 19, 2020.
  • 20% of organizations said they faced a security breach as a result of a remote worker.

 

Norton LifeLock Advantage     

We are excited to announce a new partnership with NortonLifeLock for SMB with two or more employees, provide a cybersecurity offering to their employees. As a global leader in consumer cyber safety, NortonLifeLock has built a comprehensive and easy-to-use integrated portfolio that prevents, detects, and responds to cyber threats and cybercriminals in today’s digital world. With over four decades of experience in cybersecurity and identity theft protection, NortonLifeLock helps people live their digital lives safely and has earned the trust of over 80 million users in more than 150 countries. Learn more in this short video.

Everyday actions including online shopping, banking, and even simply browsing the internet can expose your clients’ personal information and make them more vulnerable to cybercriminals. Since cybercrime has evolved, NortonLifeLock has evolved as well. LifeLock, a leader in identity theft protection, and Norton, a pioneer in consumer cybersecurity, are now one company. Their innovative employee benefit plans will help protect an employee’s identity, personal information, and connected devices against the myriad of threats they may face in their digitally connected homes, workplaces, and when using public Wi-Fi.

If you see something say something.  The bad guys only have to get it right once, we need to get it right every time!

Our WIA Cyber Team and helpdesk are here to help our clients. . Take a company audit, your preparedness is your responsibility.

 

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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FEDERAL JAN 1st SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

FEDERAL JAN 1st SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

A little-known requirement but most important under Affordable Care Act (ACA) is for Health Insurers must waive their minimum employer-contribution and employee-participation rules once a year. ACA requires a one-month Special Open Enrollment Window for January 1st coverage.

The special open enrollment period occurs November 15th through December 15th of each year, allowing eligible small group employers to enroll for coverage effective January 1st of the following year.

Background

The ACA has a section in it called the “guaranteed issuance of coverage in the individual and group market.” It stipulates that “each health insurer that offers health insurance coverage in the individual or group market in the state must accept every employer and individual in the state that applies for such coverage.” The section also states that this guaranteed issuance of coverage can only be offered during (special) open enrollment periods, and that plans can only be offered to applicants that live in, work in, or reside in the plans’ service area(s).

Participation and Contribution Requirements

In many states (including California and Nevada), carriers can decline to issue group health coverage if fewer than 70% of employees elect to enroll in coverage. Some carriers may have even tighter participation requirements.

Generally speaking, employees with other coverage (Medicare, other group coverage, individual coverage through the Exchange, etc.) are removed from the participation requirement calculation – though it varies by insurance carrier.

Furthermore, employer contribution rules require employers to contribute a certain percentage of premium costs for all employees in order to attain group health coverage. Some businesses struggle to meet these contribution requirements for a variety of financial reasons.

Problem Solved: Special Open Enrollment Period

Many employers want to offer coverage to their employees, but are denied because they struggle to meet participation and/or contribution requirements. Employers cannot force employees to enroll in coverage unless the employer pays for 100% of the employees’ premiums, which many employers cannot afford. Even with moderate to generous employer contributions, many employers still find young and lower-income employees waiving coverage. This was even more evident in 2019 with the ACA’s federal Individual Mandate non-compliance penalty reduced to $0.00.

The U.S. Department of Health & Human Services provides final guidance on this in regulation 147.104(b)(1): “In the case of health insurance coverage offered in the small group market, a health insurance issuer may limit the availability of coverage to an annual enrollment period that begins November 15 and extends through December 15 of each year in the case of a plan sponsor that is unable to comply with a material plan provision relating to employer contribution or group participation rules.”

If your employer groups are struggling with participation and/or contribution, the Special Open Enrollment Window is the time to enroll them in coverage.

For more help with the Special Open Enrollment Window contact us at info@medicalsolutionscorp.com or (855)667-4621.

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2022 Open Enrollment Checklist

2022 Open Enrollment Checklist

2022 Open Enrollment Checklist

To download this entire document as a PDF, click here: Open Enrollment eBook

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

In preparation for open enrollment, Employers should review their plan documents in light of changes for the plan year beginning Jan 1, 2021. Below is an Employer 2 Open Enrollment Checklist including some administrative items to prepare for in 2020. 

Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, when applicable—for example, the summary of benefits and coverage (SBC). There are also some participant notices that must be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.

PLAN DESIGN CHANGES

Out-of-pocket Maximum

Effective for plan years beginning on or after Jan. 1, 2014, non-grandfathered health plans are subject to limits on cost-sharing for essential health benefits (EHB). The ACA’s out-of-pocket maximum applies to all non-grandfathered group health plans, including self-insured health plans and insured plans.

  • $8,700 for self-only coverage and $17,400 for family coverage out-of-pocket maximum.
  •  $7,050 for self-only coverage and $14,100 for family coverage HSA Maximum. For 2021 plan years, the out-of-pocket maximum limit for HDHPs is $7,000 for self-only coverage and $14,000 for family coverage. 

Preventive Care Benefits 

The ACA requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements (that is, deductibles, copayments or coinsurance) for the services. Health plans are required to adjust their first-dollar coverage of preventive care services based on the latest preventive care recommendations. If you have a non-grandfathered plan, you should confirm that your plan covers the latest recommended preventive care services without imposing any cost-sharing.  

More information on the recommended preventive care services is available through the U.S. Preventive Services Task Force and www.HealthCare.gov.

Health FSA Contributions

The ACA imposes a dollar limit on employees’ salary reduction contributions to a health flexible spending account (FSA) offered under a cafeteria plan. An employer may impose its own dollar limit on employees’ salary reduction contributions to a health FSA, as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year. 

The ACA set the health FSA contribution limit at $2,500. For years after 2013, the dollar limit is indexed for cost-of-living adjustments. For 2022 plan years, the health FSA limit is $2,850. The DFSA Rollover Maximum is $570. 

  • Communicate the health FSA limit to employees as part of the open enrollment process.

HDHP and HSA Limits for 2022

If you offer an HDHP to your employees that is compatible with an HSA, you should confirm that the HDHP’s minimum deductible and out-of-pocket maximum comply with the 2020 limits. The IRS limits for HSA contributions and HDHP cost-sharing increase for 2022. The HSA contribution limits will increase effective Jan. 1, 2022, while the HDHP limits will increase effective for plan years beginning on or after Jan. 1, 2022.

  • Check whether your HDHP’s cost-sharing limits need to be adjusted for the 2022 limits.
  • If you communicate the HSA contribution limits to employees as part of the enrollment process, these enrollment materials should be updated to reflect the increased limits that apply for 2022.

The following table contains the HDHP and HSA limits for 2022 as compared to 2021. It also includes the catch-up contribution limit that applies to HSA-eligible individuals who are age 55 or older, which is not adjusted for inflation and stays the same from year to year.

Type of Limit20212022Change
HSA Contribution LimitSelf-only$3,600$3,650Up $50
Family$7,200$7,300Up $100
HSA Catch-up Contributions (not subject to adjustment for inflation)Age 55 or older$1,000$1,000No change
HDHP Minimum DeductibleSelf-only$1,400$1,400No change
Family$2,800$2,800No change
HDHP Maximum Out-of-pocket Expense Limit (deductibles, copayments and other amounts, but not premiums)Self-only$7,000$7,050Up $50
Family$14,000$14,100Up $100

 

ACA EMPLOYER MANDATE AND OTHER REQUIREMENTS 

 

Applicable Large Employer Status (ALE)

Under the ACA’s employer penalty rules, applicable large employers (ALEs) that do not offer health coverage to their full-time employees (and dependent children) that is affordable and provides minimum value will be subject to penalties if any full-time employee receives a government subsidy for health coverage through an Exchange.

To qualify as an ALE, an employer must employ, on average, at least 50 full-time employees, including full-time equivalent employees (FTEs), on business days during the preceding calendar year. All employers that employ at least 50 full-time employees, including FTEs, are subject to the ACA’s pay or play rules.

  • Determine your ALE status for 2022
  • Calculate the number of full-time employees for all 12 calendar months of 2020. A full-time employee is an employee who is employed on average for at least 30 hours of service per week.
  • Calculate the number of FTEs for all 12 calendar months of 2021 by calculating the aggregate number of hours of service (but not more than 120 hours of service for any employee) for all employees who were not full-time employees for that month and dividing the total hours of service by 120.
  • Add the number of full-time employees and FTEs (including fractions) calculated above for all 12 calendar months of 2021.
  • Add up the monthly numbers from the preceding step and divide the sum by 12. Disregard fractions.
  • If your result is 50 or more, you are likely an ALE for 2022.

Identify Full-time Employees

All full-time employees must be offered affordable minimum value coverage.  A full-time employee is an employee who was employed on average at least 30 hours of service per week. The final regulations generally treat 130 hours of service in a calendar month as the monthly equivalent of 30 hours of service per week. The IRS has provided two methods for determining full-time employee status—the monthly measurement method and the look-back measurement method.

  • Determine which method you are going to use to determine full-time status
  • The monthly measurement method involves a month-to-month analysis where full-time employees are identified based on their hours of service for each month. This method is not based on averaging hours of service over a prior measurement method. Month-to-month measuring may cause practical difficulties for employers, particularly if there are employees with varying hours or employment schedules, and could result in employees moving in and out of employer coverage on a monthly
  • The look-back measurement method allows an employer to determine full-time status based on average hours worked by an employee in a prior period. This method involves a measurement period for counting/averaging hours of service, an administrative period that allows time for enrollment and disenrollment, and a stability period when coverage may need to be provided, depending on an employee’s average hours of service during the measurement 

Audit FTEs for FMLA Compliance

Audit your FTEs to determine if you have reached or exceeded 50 employees and are required to comply with the Family Medical Leave Act (FMLA) in 2022. Employers covered by the FMLA are obligated to provide their employees with certain important FMLA notices, so both employees and the employer have a shared understanding of the terms of the FMLA leave. Note that FMLA compliance requirements are different from ACA compliance. 

Offer of Coverage 

An ALE may be liable for a penalty under the pay or play rules if it does not offer coverage to “substantially all” (95%) full-time employees (and dependents) and any one of its full-time employees receives a premium tax credit or cost-sharing reduction for coverage purchased through an Exchange. For employees who are offered health coverage that is affordable and provides minimum value are generally not eligible for these Exchange subsidies.  The IRS lowered the 2022 employer health plan affordability threshold, or cost-sharing limit, to 9.61% of an employee’s income. The threshold in 2021 was 9.83%. 

  • Offer minimum essential coverage to all full-time employees
  • Ensure that at least one of those plans provides minimum value (60% actuarial value)
  • Ensure that the minimum value plan offered is affordable to all full-time employees by ensuring that the employee contribution for the lowest cost single minimum value plan does not exceed 78% of an employee’s earnings based on the employee’s W-2 wages, the employee’s rate of pay, or the federal poverty level for a single individual.

Reporting of Coverage

The ACA requires ALEs to report information to the IRS and to employees regarding the employer-sponsored health coverage on Form 1095-C. The IRS will use the information that ALEs report to verify employer-sponsored coverage and to administer the employer shared responsibility provisions (Code Section 6056).

In addition, the ACA requires every health insurance issuer, sponsor of a self-insured health plan, a government agency that administers government-sponsored health insurance programs and any other entity that provides minimum essential coverage (MEC) to file an annual return with the IRS and individuals reporting information for each individual who is provided with this coverage (Code Section 6055). 

  • Determine which reporting requirements apply to you and your health plans
  • Determine the information you will need for reporting and coordinate internal and external resources to help compile the required data for the   1094-C and 1095-C
  • Complete the appropriate forms for the 2020 reporting year. Furnish statements to individuals on or before January 31, 2021 has been extended to March 2, 2021 IRS Notice 2020-76., and file returns with the IRS on or before February 28, 2020 (March 31, 2020, if filing electronically).
ACA RequirementDeadline
1095 forms delivered to employeesJan. 31 (extended to March 2)
Paper filing with IRS*Feb. 28
Electronic filing with IRSMarch 31

Comparative Effectiveness Research Fee (PCORI)

Sponsors of self-funded plans and health insurance issuers of fully insured plans are required to pay a fee each year, by July 31st, to fund comparative effectiveness research. Fees will increase to $2.45 per covered life in 2020 and are next due July 31, 2021.

W-2 Reporting

Healthcare Reform requires employers to report the aggregate cost of employer-sponsored group health plan coverage on their employees’ Forms W-2. This reporting requirement was originally effective for the 2011 tax year. However, the IRS later made reporting optional for 2011 for all employers.

The IRS further delayed the reporting requirement for small employers (those that file fewer than 250 Forms W-2) by making it optional for these employers until further guidance is issued. For the larger employers, the reporting requirement was mandatory for the 2012 Forms W-2 and continues.

ACA DISCLOSURE REQUIREMENTS

Summary of Benefits and Coverage 

The ACA requires health plans and health insurance issuers to provide an SBC to applicants and enrollees to help them understand their coverage and make coverage decisions. Plans and issuers must provide the SBC to participants and beneficiaries who enroll or re-enroll during an open enrollment period. The SBC also must be provided to participants and beneficiaries who enroll other than through an open enrollment period (including those who are newly eligible for coverage and special enrollees).

The SBC template and related materials are available from the Department of Labor (DOL).

  • In connection with a plan’s 2020 open enrollment period, the SBC should be included with the plan’s application materials. If coverage automatically renews for current participants, the SBC must generally be provided no later than 30 days before the beginning of the new plan year.
  • For self-funded plans, the plan administrator is responsible for providing the SBC. For insured plans, both the plan and the issuer are obligated to provide the SBC, although this obligation is satisfied for both parties if either one provides the SBC. Thus, if you have an insured plan, you should confirm that your health insurance issuer will assume responsibility for providing the SBCs.

Grandfathered Plan Notice

If you have a grandfathered plan, make sure to include information about the plan’s grandfathered status in plan materials describing the coverage under the plan, such as SPDs and open enrollment materials. Model language is available from the DOL. 

Notice of Patient Protections

Under the ACA, non-grandfathered group health plans and issuers that require designation of a participating primary care provider must permit each participant, beneficiary and enrollee to designate any available participating primary care provider (including a pediatrician for children). Also, plans and issuers that provide obstetrical/gynecological care and require a designation of a participating primary care provider may not require preauthorization or referral for obstetrical/gynecological care.

If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of these patient protections whenever the SPD or similar description of benefits is provided to a participant. If your plan is subject to this notice requirement, you should confirm that it is included in the plan’s open enrollment materials. Model language is available from the DOL.

 

OTHER NOTICES 

Group health plan sponsors should consider including the following enrollment and annual notices with the plan’s open enrollment materials. 

  • Initial COBRA Notice 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to employers with 20 or more employees that sponsor group health plans.  Plan administrators must provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. The initial COBRA notice may be incorporated into the plan’s SPD.  A model initial COBRA notice is available from the DOL.

  • Notice of HIPAA Special Enrollment Rights

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 may be included in the plan’s SPD.   Model language for this disclosure is available on the DOL’s website.

  • Annual CHIPRA Notice

Group health plans covering residents in a state that provides a premium subsidy to low-income children and their families to help pay for employer-sponsored coverage must send an annual  notice about the available assistance to all employees residing in that state. The DOL has provided a model notice.

  • WHCRA Notice

Plans and issuers must provide notice of participants’ rights to mastectomy-related benefits under the Women’s Health and Cancer Rights Act (WHCRA) at the time of enrollment and on an annual basis.  Model language for this disclosure is available on the DOL’s website.

  • NMHPA Notice

Plan administrators must include a statement within the Summary Plan Description (SPD) timeframe describing requirements relating to any hospital length of stay in connection with childbirth for a mother or newborn child under the Newborns’ and Mothers’ Health Protections Act. Model language for this disclosure is available on the DOL’s website.

  • Medicare Part D Notices

Group health plan sponsors must provide a notice of creditable or non-creditable prescription drug coverage to Medicare Part D eligible individuals who are covered by, or who apply for, prescription drug coverage under the health plan. This creditable coverage notice alerts the individuals as to whether or not their prescription drug coverage is at least as good as the Medicare Part D coverage. The notice generally must be provided at various times, including when an individual enrolls in the plan and each year before Oct. 15th (when the Medicare annual open enrollment period begins).  Model notices are available on the Centers for Medicare and Medicaid Services’ website.

  • HIPAA Privacy Notice

The HIPAA Privacy Rule requires covered entities (including group health plans and issuers) to provide a Notice of Privacy Practices (or Privacy Notice) to each individual who is the subject of protected health information (PHI). Health plans are required to send the Privacy Notice at certain times, including to new enrollees at the time of enrollment. 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.

Self-insured health plans are required 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.

Model Privacy Notices are available through the Department of Health and Human Services

  • Summary Plan Description (SPD)

Plan administrators must provide an SPD to new participants within 90 days after plan coverage begins. Any changes that are made to the plan should be reflected in an updated SPD booklet or described to participants through a summary of material modifications (SMM).

Also, an updated SPD must be furnished every five years if changes are made to SPD information or the plan is amended. Otherwise, a new SPD must be provided every 10 years. 

Summary Annual Report

Plan administrators that are required to file a Form 5500 (> 100 participants in plan) must provide participants with a narrative summary of the information in the Form 5500, called a summary annual report (SAR). The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file the Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period.

Wellness Program Notices 

Group health plans that include wellness programs may be required to provide certain notices regarding the program’s design. As a general rule, these notices should be provided when the wellness program is communicated to employees and before employees provide any health-related information or undergo medical examinations.

  • HIPAA Wellness Program Notice—HIPAA imposes a notice requirement on health-contingent wellness programs that are offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (for example, not smoking) in order to obtain rewards. The notice must disclose the availability of a reasonable alternative standard to qualify for the reward (and, if applicable, the possibility of waiver of the otherwise applicable standard) in all plan materials describing the terms of a health-contingent wellness program. Final regulations provide sample language that can be used to satisfy this requirement.
  • ADA Wellness Program Notice—Employers with 15 or more employees are subject to the Americans with Disabilities Act (ADA). Wellness programs that include health-related questions or medical examinations must comply with the ADA’s requirements, including an employee notice requirement. Employers must give participating employees a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared and for what purpose, the limits on disclosure and the way information will be kept confidential. The Equal Employment Opportunity Commission (EEOC) has provided a sample notice to help employers comply with this ADA requirement.

 

 

 

Enhance Your Employee Benefits Package.  A competitive benefits package is key to keeping and attracting top talent.  Assess your current benefits package and consider making necessary adjustments to include options, such as expanded mental health support, for example. 

GENERAL HR  

Review Employee Records.  The fourth quarter is a good time to review your employee records and check record retention guidelines. Don’t forget to dispose of outdated termination and outdated job applications properly. With W2s around the corner, make sure all addresses and information are updated.

Develop and Distribute Your 2022 Calendar.  Create and distribute a calendar outlining important dates, vacation time, pay dates, and company-observed holidays for 2022. 

Review and Update Employee Handbook. Review your employee handbook to make sure it is up-to-date and addresses areas, such as employment law mandates, new COVID-related policies, guidelines for remote working, privacy policies, compensation and performance reviews, social media policies, attendance, and time-off, break periods, benefits, and procedures for termination, discipline, workplace safety, and emergency procedures.

PLEASE NOTE: This information is for general reference purposes only. Because laws, regulations, and filing deadlines are likely to change, please check with the appropriate organizations or government agencies for the latest information and consult your employment attorney and/or benefits advisor regarding your responsibilities. In addition, your business may be exempt from certain requirements and/or be subject to different requirements under the laws of your state. (Updated Oct. 3, 2021)

Contact us at (855) 667-4621 or email us at info@medicalsolutionscorp.com

 

Learn more about

 Liability Protection        •        Employee Benefits       •        HR Consulting

 

Employee Retention Tax Credit

Employee Retention Tax Credit

Employee Retention Tax Credits under CARES ACT have been available yet there has been confusion surrounding this. Employee Retention Tax Credits (ERTC). Much of this has been covered under Corona Virus Resource Page –What the Coronavirus Means for Your Business.   The ERTC was extended and modified by the Consolidated Appropriations Act of 2021. 

COVID-19 Employee Retention Credit available for Businesses Financially Impacted

The Treasury Department and the Internal Revenue Service today launched the Employee Retention Credit, designed to encourage businesses to keep employees on their payroll. The refundable tax credit is 50% of up to $10,000 in wages paid by an eligible employer whose business has been financially impacted by COVID-19.

FAQ

Does my business qualify to receive the Employee Retention Credit?

The credit is available to all employers regardless of size, including tax-exempt organizations. There are only two exceptions: State and local governments and their instrumentalities and small businesses who take small business loans.

Qualifying employers must fall into one of two categories:

1.The employer’s business is fully or partially suspended by government order due to COVID-19 during the calendar quarter.

2. The employer’s gross receipts are below 50% of the comparable quarter in 2019. Once the employer’s gross receipts go above 80% of a comparable quarter in 2019, they no longer qualify after the end of that quarter.

How is the credit calculated?

The amount of the credit is 50% of qualifying wages paid up to $10,000 in total. Wages paid after March 12, 2020, and before Jan. 1, 2021, are eligible for the credit. Wages taken into account are not limited to cash payments, but also include a portion of the cost of employer-provided health care.

How do I know which wages qualify?

Qualifying wages are based on the average number of a business’s employees in 2019.Employers with less than 100 employees: If the employer had 100 or fewer employees on average in 2019, the credit is based on wages paid to all employees, regardless if they worked or not. If the employees worked full time and were paid for full-time work, the employer still receives the credit.

Employers with more than 100 employees: If the employer had more than 100 employees on average in 2019, then the credit is allowed only for wages paid to employees who did not work during the calendar quarter.

I am an eligible employer. How do I receive my credit?

Employers can be immediately reimbursed for the credit by reducing their required deposits of payroll taxes that have been withheld from employees’ wages by the amount of the credit.

Eligible employers will report their total qualified wages and the related health insurance costs for each quarter on their quarterly employment tax returns or Form 941 beginning with the second quarter. If the employer’s employment tax deposits are not sufficient to cover the credit, the employer may receive an advance payment from the IRS by submitting Form 7200, Advance Payment of Employer Credits Due to COVID-19.

Eligible employers can also request an advance of the Employee Retention Credit by submitting Form 7200.

Where can I find more information on the Employer Retention Credit and other COVID-19 economic relief efforts?

Updates on the implementation of this Employee Retention Credit, Frequently Asked Questions on Tax Credits for Required Paid Leave and other information can be found on the Coronavirus page of IRS.gov.

Do you have a Checklist for the Paycheck Protection Loans Documentations?

Start preparing NOW. Gather documents that provide proof of payment for allowable expenses under the Paycheck Protection Program and be ready to make related certifications for the application.

I’m working with a PEO, how do I get these forms to the IRS?

When partnering with a PEO, the PEO may request an attestation from the client or the client‘s CPA  certifying that the client qualifies for the ERTC.  This is because the PEO is unable to verify that the client incurred a reduction in gross receipts or otherwise qualified for the credit.  Furthermore, indemnification may be requestedgiven that incongruities with claiming the credit must be reconciled on the PEOs Form 941.  Finally, in order to prevent multiple filings, it is possible that a PEO may establish deadlines for clients claiming the ERTC and impose an administrative fee associated with processing the ERTC for former clients or clients seeking to claim the credit outside of specified time frames.

For more information about the ERTC, please contact your PEO service provider.

Paycheck Protection Program Document Checklist and Certifications

Resource:

ERTC Video Explainer

Silver Linings Pandemic Playbook  – American Benefits Council

 

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

HSA 2023 Dollar Limits

HSA 2022 Limits Released

HSA 2022 Limits Released

The IRS has released the 2022  Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

New HSA 2022 limits are as follows:

 

2022

2021

HSA Annual Contribution Limit
$3,650;  $7,300
$3,600 – Single; $7,200 – Family
HDHP Minimum Annual Deductible
$1,400;  $2,800
$1,400 – Single; $2,800 – Family
HDHP Out-of-Pocket Maximum
$7,050;  $14,100
$7,000 – Single; $14,000 – Family
Age 55+ Catch-Up Provision
$1,000;  $2,000
$1,000- Single; $2,000 – H/W 

Age 55 Catch Up Contribution

As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of the year, you can contribute an additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute an additional $1,000. A savvy strategy for high-income earners is to invest the money in your HSA for the long haul. Once you’re 65, you can take out tax-free distributions to cover Medicare premiums. If you withdraw money at that point for non-medical uses, you pay the same tax as you would on withdrawals from a pretax 401(k). But you can also take money out tax-free to reimburse yourself for prior years’ out-of-pocket medical expenses if you have the old receipts.


COVId-19 Update: 

You can even use an HSA to save on a typical trip to the CVS. Thanks to a tax relief provision tucked in the last Covid-19 stimulus package, you can use the money you stash in an HSA or FSA (more on those later) for over-the-counter medications like Tylenol or Flonase as well as menstrual products like tampons and pads. That reverses Obamacare restrictions on OTC meds requiring a doctor’s prescription for them to be eligible for reimbursement.

 

HSA/HDHP Market Growth

HSA holders own the assets in the accounts and can build up substantial sums over time.  Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.

FSA Store

HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.

  • The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
  • 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
  •  14% of all workers in the private sector have access to a Health Savings Account acc. to the Bureau of Labor Statistics.
  • States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois, and Minnesota.

HSA Advantages:

  • Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
  • Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
  • Tax-Free Money allowed for non-traditional Medical coverage– As per IRS Publication 502, unused money can be used for dental, vision, Lasik eye surgery, acupuncture, yoga, infertility, etc.  Popular Examples
  • Portability – The funds belong to you, so you keep the funds if you change jobs or retire.

Our overall experience with HSAs has been positive when employer funding is at a minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money).  Traditional plans trend of higher copays and new in-network deductibles has also led to the popularity of an HSA.

Next Steps

Plan sponsors should update payroll and plan administration systems for the 2022 cost-of-living adjustments and should incorporate the new limits in relevant participant communications, such as open enrollment and communication materials, plan documents, and summary plan descriptions.

RESOURCE:

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for the latest news updates.

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PEO White Papers: The PEO Industry Footprint in 2021

PEO White Papers: The PEO Industry Footprint in 2021

PEO White Papers: The PEO Industry Footprint in 2021

Professional employer organizations (PEOs) provide comprehensive HR solutions for small and mid-sized businesses by supplying them with a broad array of cost-effective HR offerings and expertise. This enables PEO clients to concentrate on growing their businesses while offering superior benefits and HR practices to their employees. Research in our previous white papers has shown multiple positive effects from these services: PEO clients enjoy a better chance of survival, higher growth rates, lower employee turnover, higher employee satisfaction, and they fared better during the COVID-19 pandemic.

KEY FINDINGS:

NAPEO’s White Paper series aims to help the general public and small business owners better understand the economic impact and value of the PEO industry and the ways working with a PEO can help businesses grow and thrive.

Our white papers have shown that:

  • Businesses in a PEO arrangement grow 7-9 percent faster, have 10-14 percent lower turnover, and are 50 percent less likely to go out of business.

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  • PEOs are able to offer a broad array of HR services at a lower cost and offer access to retirement plans to small businesses that may not otherwise sponsor them.
  • PEOs provide services to 175,000 small and mid-sized businesses, employing 3.7 million people.
  • There are 907 PEOs in the United States.
  • The total employment represented by the PEO industry is roughly the same as the combined number of employees for Walmart (United States only), Amazon, IBM, FedEx, Starbucks, AT&T, Wells Fargo, Apple, and Google.
  • The PEO industry’s 175,000 clients represent 15 percent of all employers with 10 to 99 employees.
  • Administrative costs are around $450 lower per employee for businesses that use a PEO.

 

Learn how our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

PPE Expenses May Be Reimbursable Under HSA

PPE Expenses May Be Reimbursable Under HSA

PPE Expenses May Be Reimbursable Under Health Spending Accounts – Video

During the COVID-19 pandemic, you may have purchased masks or PPE for the purpose of preventing the spread of the COVID-19. Now, according to a recent announcement from the IRS, those purchases may be deductible from your income for tax purposes and eligible to be paid or reimbursed under certain savings accounts. This video explains further:

If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

PEO Pros and Cons

PEO Pros and Cons

When choosing the right PEO, especially when it comes to human resource management, you should ensure that they offer basic HR services like benefits, payroll, and compliance.

Pros of PEO

1. Flexible, scalable:

Bundled HR solution covers you as you grow.  i.e. Compliance changes based on # of employees. The HR Platform can handle 10 as well as 200 employees. The benefits scale up as you do. You are able to include value-added services as you grow.

2. Access to “Big-Company” infrastructure and benefits

  • More health care benefit options for employees and their families mean:
    • Attract high caliber talent in your industry
    • Retain your best employees
  • 401(k) and retirement planning 
  • Top-rated voluntary benefits and discount programs
  • HR technology platform for administering benefit plans

3.  Access to HR expertise

  • Support for payroll and employee needs.
  • HR and Human Capital consultants.
    • Benefits administration
    • Employee issues
    • Strategic HR planning:  Interview Traning and Permanence Management Reviews, etc. 
  • Ensure HR compliance with local, state and federal laws.

4. Shifting and sharing of liability

  • Workplace safety
  • Sexual Harassment
  • Employer Practices Liability Insurance
  • Affordable Care Act compliance
  • COVID and New regulations

5. Value

  • Time Saver:  You get back valuable time from doing redundancies. The average PEO client saves 10 hrs/month. 
  • Benefits Savings:  The average client saves 15-40% on medical benefits alone.   The national networks and robust benefits are also value-added. 
  • Savings on Workmans Comp. 
    • PEO’s are pay as you go WC. This means if you downsized in light of COVID you receive an adjusted lower rate the following month and not end of the year. 
    • PEO’s may be able to place hard to write Workmans Comp. Ex: Construction Industry
  • State Unemployment:  Since you are sharing in a larger company’s SUTA rate the rates are generally lower with lower fluctuations. If during COVID a company had high turnover their SUTA rate can jump much higher than a PEO. 

 PEO Cons

1. Wrong PEO Selecting a PEO for the wrong reason(s): should be considered a long-term strategy, not a short-term fix.  Some PEOs may charge a percentage of salary instead of a clear per employee per month cost.  

2. Employers fear the loss of controEven though you will still be running your small business and making day to day decisions, the PEO will become the co-employer of your staff.  PEOs do NOT have control over your salary. You control who you hire/fire.  You decide on benefits eligibility waiting periods, plan selections, and employer contributions. The PEOs deal with HR responsibilities and risks, saving you countless hours and many headaches, but do not take away your independence.

3  System limitations   Because the PEO is a business as well, and has to meet it’s own deadlines, they may request certain payments upfront. This may mean a fundamental shift in your cash flow because there will be consequences for being a week late with your payroll taxes.

4. It is NOT for every small business depending on your industry and demographics you may or may not be the right for a PEO. While the vast majority of clients are indeed enjoying benefits savings for some groups the costs may be even higher than small group health insurance. Addiotnaly, some companies can develop above-average very high risk and become too much of a liability burden for the PEO and the client can be moved to a higher risk category. The very advantage of a PEO can make it a disadvantage – they can underwrite.  

Summary

Before you consider hiring a Professional Employment Organization, you should first find out what is a PEO so that you can know exactly what to expect from it. With the right PEO, you will be able to manage your businesses’ demand for growth and your employees as well. 

If you are looking for an insurance solution for your business, go to our website and check out our business insurance solutions. Do not hesitate to contact us for more information.

 

 

 

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For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP. 

JAN 1 SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

JAN 1 SMALL GROUP ANNUAL OPEN ENROLLMENT WAIVER

A little-known requirement but most important under Affordable Care Act (ACA) is for Health Insurers must waive their minimum employer-contribution and employee-participation rules once a year. ACA requires a one-month Special Open Enrollment Window for January 1st coverage.

The special open enrollment period occurs November 15th through December 15th of each year, allowing eligible small group employers to enroll for coverage effective January 1st of the following year.

Background

The ACA has a section in it called the “guaranteed issuance of coverage in the individual and group market.” It stipulates that “each health insurer that offers health insurance coverage in the individual or group market in the state must accept every employer and individual in the state that applies for such coverage.” The section also states that this guaranteed issuance of coverage can only be offered during (special) open enrollment periods, and that plans can only be offered to applicants that live in, work in, or reside in the plans’ service area(s).

Participation and Contribution Requirements

In many states (including California and Nevada), carriers can decline to issue group health coverage if fewer than 70% of employees elect to enroll in coverage. Some carriers may have even tighter participation requirements.

Generally speaking, employees with other coverage (Medicare, other group coverage, individual coverage through the Exchange, etc.) are removed from the participation requirement calculation – though it varies by insurance carrier.

Furthermore, employer contribution rules require employers to contribute a certain percentage of premium costs for all employees in order to attain group health coverage. Some businesses struggle to meet these contribution requirements for a variety of financial reasons.

Problem Solved: Special Open Enrollment Period

Many employers want to offer coverage to their employees, but are denied because they struggle to meet participation and/or contribution requirements. Employers cannot force employees to enroll in coverage unless the employer pays for 100% of the employees’ premiums, which many employers cannot afford. Even with moderate to generous employer contributions, many employers still find young and lower-income employees waiving coverage. This was even more evident in 2019 with the ACA’s federal Individual Mandate non-compliance penalty reduced to $0.00.

The U.S. Department of Health & Human Services provides final guidance on this in regulation 147.104(b)(1): “In the case of health insurance coverage offered in the small group market, a health insurance issuer may limit the availability of coverage to an annual enrollment period that begins November 15 and extends through December 15 of each year in the case of a plan sponsor that is unable to comply with a material plan provision relating to employer contribution or group participation rules.”

If your employer groups are struggling with participation and/or contribution, the Special Open Enrollment Window is the time to enroll them in coverage.

For more help with the Special Open Enrollment Window contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

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For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

2022 Open Enrollment Checklist

2021 Open Enrollment Checklist

2021 Open Enrollment Checklist

To download this entire document as a PDF, click here: Open Enrollment eBook

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

In preparation for open enrollment, Employers should review their plan documents in light of changes for the plan year beginning Jan 1, 2021. Below is an Employer 2 Open Enrollment Checklist including some administrative items to prepare for in 2020. 

Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, when applicable—for example, the summary of benefits and coverage (SBC). There are also some participant notices that must be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.

PLAN DESIGN CHANGES

 

Out-of-pocket Maximum

Effective for plan years beginning on or after Jan. 1, 2014, non-grandfathered health plans are subject to limits on cost-sharing for essential health benefits (EHB). The ACA’s out-of-pocket maximum applies to all non-grandfathered group health plans, including self-insured health plans and insured plans.

  • $8,550 for self-only coverage and $17,100 for family coverage  out-of-pocket maximum.
  •  $7,000 for self-only coverage and $14,000 for family coverage HSA Maximum. For 2021 plan years, the out-of-pocket maximum limit for HDHPs is $7,000 for self-only coverage and $14,000 for family coverage. 

Preventive Care Benefits 

The ACA requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements (that is, deductibles, copayments or coinsurance) for the services. Health plans are required to adjust their first-dollar coverage of preventive care services based on the latest preventive care recommendations. If you have a non-grandfathered plan, you should confirm that your plan covers the latest recommended preventive care services without imposing any cost-sharing.  

More information on the recommended preventive care services is available through the U.S. Preventive Services Task Force and www.HealthCare.gov.

Health FSA Contributions

The ACA imposes a dollar limit on employees’ salary reduction contributions to a health flexible spending account (FSA) offered under a cafeteria plan. An employer may impose its own dollar limit on employees’ salary reduction contributions to a health FSA, as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year. 

The ACA set the health FSA contribution limit at $2,500. For years after 2013, the dollar limit is indexed for cost-of-living adjustments. For 2021 plan years, the health FSA limit is $2,750. 

  • Communicate the health FSA limit to employees as part of the open enrollment process.

HDHP and HSA Limits for 2021

If you offer an HDHP to your employees that is compatible with an HSA, you should confirm that the HDHP’s minimum deductible and out-of-pocket maximum comply with the 2020 limits. The IRS limits for HSA contributions and HDHP cost-sharing increase for 2020. The HSA contribution limits will increase effective Jan. 1, 2020, while the HDHP limits will increase effective for plan years beginning on or after Jan. 1, 2020.

  • Check whether your HDHP’s cost-sharing limits need to be adjusted for the 2020 limits.
  • If you communicate the HSA contribution limits to employees as part of the enrollment process, these enrollment materials should be updated to reflect the increased limits that apply for 2020.

The following table contains the HDHP and HSA limits for 2020 as compared to 2019. It also includes the catch-up contribution limit that applies to HSA-eligible individuals who are age 55 or older, which is not adjusted for inflation and stays the same from year to year.

Type of Limit20202021Change
HSA Contribution LimitSelf-only$3,500$3,600Up $50
Family$7,100$7,200Up $100
HSA Catch-up Contributions (not subject to adjustment for inflation)Age 55 or older$1,000$1,000No change
HDHP Minimum DeductibleSelf-only$1,400$1,400No change
Family$2,800$2,800No change
HDHP Maximum Out-of-pocket Expense Limit (deductibles, copayments and other amounts, but not premiums)Self-only$6,900$7,000Up $100
Family$13,800$14,000Up $200

 

ACA EMPLOYER MANDATE AND OTHER REQUIREMENTS 

 

Applicable Large Employer Status (ALE)

Under the ACA’s employer penalty rules, applicable large employers (ALEs) that do not offer health coverage to their full-time employees (and dependent children) that is affordable and provides minimum value will be subject to penalties if any full-time employee receives a government subsidy for health coverage through an Exchange.

To qualify as an ALE, an employer must employ, on average, at least 50 full-time employees, including full-time equivalent employees (FTEs), on business days during the preceding calendar year. All employers that employ at least 50 full-time employees, including FTEs, are subject to the ACA’s pay or play rules.

  • Determine your ALE status for 2021
  • Calculate the number of full-time employees for all 12 calendar months of 2020. A full-time employee is an employee who is employed on average for at least 30 hours of service per week.
  • Calculate the number of FTEs for all 12 calendar months of 2020 by calculating the aggregate number of hours of service (but not more than 120 hours of service for any employee) for all employees who were not full-time employees for that month and dividing the total hours of service by 120.
  • Add the number of full-time employees and FTEs (including fractions) calculated above for all 12 calendar months of 2020.
  • Add up the monthly numbers from the preceding step and divide the sum by 12. Disregard fractions.
  • If your result is 50 or more, you are likely an ALE for 2021.

Identify Full-time Employees

All full-time employees must be offered affordable minimum value coverage.  A full-time employee is an employee who was employed on average at least 30 hours of service per week. The final regulations generally treat 130 hours of service in a calendar month as the monthly equivalent of 30 hours of service per week. The IRS has provided two methods for determining full-time employee status—the monthly measurement method and the look-back measurement method.

  • Determine which method you are going to use to determine full-time status
  • Monthly measurement method involves a month-to-month analysis where full-time employees are identified based on their hours of service for each month. This method is not based on averaging hours of service over a prior measurement method. Month-to-month measuring may cause practical difficulties for employers, particularly if there are employees with varying hours or employment schedules, and could result in employees moving in and out of employer coverage on a monthly
  • Look-back measurement method allows an employer to determine full-time status based on average hours worked by an employee in a prior period. This method involves a measurement period for counting/averaging hours of service, an administrative period that allows time for enrollment and disenrollment, and a stability period when coverage may need to be provided, depending on an employee’s average hours of service during the measurement 

Offer of Coverage 

An ALE may be liable for a penalty under the pay or play rules if it does not offer coverage to “substantially all” (95%) full-time employees (and dependents) and any one of its full-time employees receives a premium tax credit or cost-sharing reduction for coverage purchased through an Exchange. Employees who are offered health coverage that is affordable and provides minimum value are generally not eligible for these Exchange subsidies.

  • Offer minimum essential coverage to all full-time employees
  • Ensure that at least one of those plans provides minimum value (60% actuarial value)
  • Ensure that the minimum value plan offered is affordable to all full-time employees by ensuring that the employee contribution for the lowest cost single minimum value plan does not exceed 78% of an employee’s earnings based on the employee’s W-2 wages, the employee’s rate of pay, or the federal poverty level for a single individual.

Reporting of Coverage

The ACA requires ALEs to report information to the IRS and to employees regarding the employer-sponsored health coverage on Form 1095-C. The IRS will use the information that ALEs report to verify employer-sponsored coverage and to administer the employer shared responsibility provisions (Code Section 6056).

In addition, the ACA requires every health insurance issuer, sponsor of a self-insured health plan, a government agency that administers government-sponsored health insurance programs and any other entity that provides minimum essential coverage (MEC) to file an annual return with the IRS and individuals reporting information for each individual who is provided with this coverage (Code Section 6055). 

  • Determine which reporting requirements apply to you and your health plans
  • Determine the information you will need for reporting and coordinate internal and external resources to help compile the required data for the   1094-C and 1095-C
  • Complete the appropriate forms for the 2020 reporting year. Furnish statements to individuals on or before January 31, 2021 has been extended to March 2, 2021 IRS Notice 2020-76., and file returns with the IRS on or before February 28, 2020 (March 31, 2020, if filing electronically).
ACA RequirementDeadline
1095 forms delivered to employeesJan. 31 (extended to March 2)
Paper filing with IRS*Feb. 28
Electronic filing with IRSMarch 31

Comparative Effectiveness Research Fee (PCORI)

Sponsors of self-funded plans and health insurance issuers of fully insured plans are required to pay a fee each year, by July 31st, to fund comparative effectiveness research. Fees will increase to $2.45 per covered life in 2020 and are next due July 31, 2021.

W-2 Reporting

Healthcare Reform requires employers to report the aggregate cost of employer-sponsored group health plan coverage on their employees’ Forms W-2. This reporting requirement was originally effective for the 2011 tax year. However, the IRS later made reporting optional for 2011 for all employers.

The IRS further delayed the reporting requirement for small employers (those that file fewer than 250 Forms W-2) by making it optional for these employers until further guidance is issued. For the larger employers, the reporting requirement was mandatory for the 2012 Forms W-2 and continues.

ACA DISCLOSURE REQUIREMENTS

Summary of Benefits and Coverage 

The ACA requires health plans and health insurance issuers to provide an SBC to applicants and enrollees to help them understand their coverage and make coverage decisions. Plans and issuers must provide the SBC to participants and beneficiaries who enroll or re-enroll during an open enrollment period. The SBC also must be provided to participants and beneficiaries who enroll other than through an open enrollment period (including those who are newly eligible for coverage and special enrollees).

The SBC template and related materials are available from the Department of Labor (DOL).

  • In connection with a plan’s 2020 open enrollment period, the SBC should be included with the plan’s application materials. If coverage automatically renews for current participants, the SBC must generally be provided no later than 30 days before the beginning of the new plan year.
  • For self-funded plans, the plan administrator is responsible for providing the SBC. For insured plans, both the plan and the issuer are obligated to provide the SBC, although this obligation is satisfied for both parties if either one provides the SBC. Thus, if you have an insured plan, you should confirm that your health insurance issuer will assume responsibility for providing the SBCs.

Grandfathered Plan Notice

If you have a grandfathered plan, make sure to include information about the plan’s grandfathered status in plan materials describing the coverage under the plan, such as SPDs and open enrollment materials. Model language is available from the DOL. 

Notice of Patient Protections

Under the ACA, non-grandfathered group health plans and issuers that require designation of a participating primary care provider must permit each participant, beneficiary and enrollee to designate any available participating primary care provider (including a pediatrician for children). Also, plans and issuers that provide obstetrical/gynecological care and require a designation of a participating primary care provider may not require preauthorization or referral for obstetrical/gynecological care.

If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of these patient protections whenever the SPD or similar description of benefits is provided to a participant. If your plan is subject to this notice requirement, you should confirm that it is included in the plan’s open enrollment materials. Model language is available from the DOL.

OTHER NOTICES 

Group health plan sponsors should consider including the following enrollment and annual notices with the plan’s open enrollment materials. 

  • Initial COBRA Notice 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to employers with 20 or more employees that sponsor group health plans.  Plan administrators must provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. The initial COBRA notice may be incorporated into the plan’s SPD.  A model initial COBRA notice is available from the DOL.

  • Notice of HIPAA Special Enrollment Rights

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 may be included in the plan’s SPD.   Model language for this disclosure is available on the DOL’s website.

  • Annual CHIPRA Notice

Group health plans covering residents in a state that provides a premium subsidy to low-income children and their families to help pay for employer-sponsored coverage must send an annual  notice about the available assistance to all employees residing in that state. The DOL has provided a model notice.

  • WHCRA Notice

Plans and issuers must provide notice of participants’ rights to mastectomy-related benefits under the Women’s Health and Cancer Rights Act (WHCRA) at the time of enrollment and on an annual basis.  Model language for this disclosure is available on the DOL’s website.

  • NMHPA Notice

Plan administrators must include a statement within the Summary Plan Description (SPD) timeframe describing requirements relating to any hospital length of stay in connection with childbirth for a mother or newborn child under the Newborns’ and Mothers’ Health Protections Act. Model language for this disclosure is available on the DOL’s website.

  • Medicare Part D Notices

Group health plan sponsors must provide a notice of creditable or non-creditable prescription drug coverage to Medicare Part D eligible individuals who are covered by, or who apply for, prescription drug coverage under the health plan. This creditable coverage notice alerts the individuals as to whether or not their prescription drug coverage is at least as good as the Medicare Part D coverage. The notice generally must be provided at various times, including when an individual enrolls in the plan and each year before Oct. 15th (when the Medicare annual open enrollment period begins).  Model notices are available on the Centers for Medicare and Medicaid Services’ website.

  • HIPAA Privacy Notice

The HIPAA Privacy Rule requires covered entities (including group health plans and issuers) to provide a Notice of Privacy Practices (or Privacy Notice) to each individual who is the subject of protected health information (PHI). Health plans are required to send the Privacy Notice at certain times, including to new enrollees at the time of enrollment. 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.

Self-insured health plans are required 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.

Model Privacy Notices are available through the Department of Health and Human Services

  • Summary Plan Description (SPD)

Plan administrators must provide an SPD to new participants within 90 days after plan coverage begins. Any changes that are made to the plan should be reflected in an updated SPD booklet or described to participants through a summary of material modifications (SMM).

Also, an updated SPD must be furnished every five years if changes are made to SPD information or the plan is amended. Otherwise, a new SPD must be provided every 10 years. 

Summary Annual Report

Plan administrators that are required to file a Form 5500 (> 100 participants in plan) must provide participants with a narrative summary of the information in the Form 5500, called a summary annual report (SAR). The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file the Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period.

Wellness Program Notices 

Group health plans that include wellness programs may be required to provide certain notices regarding the program’s design. As a general rule, these notices should be provided when the wellness program is communicated to employees and before employees provide any health-related information or undergo medical examinations.

  • HIPAA Wellness Program Notice—HIPAA imposes a notice requirement on health-contingent wellness programs that are offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (for example, not smoking) in order to obtain rewards. The notice must disclose the availability of a reasonable alternative standard to qualify for the reward (and, if applicable, the possibility of waiver of the otherwise applicable standard) in all plan materials describing the terms of a health-contingent wellness program. Final regulations provide sample language that can be used to satisfy this requirement.
  • ADA Wellness Program Notice—Employers with 15 or more employees are subject to the Americans with Disabilities Act (ADA). Wellness programs that include health-related questions or medical examinations must comply with the ADA’s requirements, including an employee notice requirement. Employers must give participating employees a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared and for what purpose, the limits on disclosure and the way information will be kept confidential. The Equal Employment Opportunity Commission (EEOC) has provided a sample notice to help employers comply with this ADA requirement.

 

 

 

Contact us at (855) 667-4621 or email us at info@360PEO.com

 

Learn more about

 Liability Protection        •        Employee Benefits       •        HR Consulting

 

2021 Dollar Limits

2021 Dollar Limits

The IRS & SSA announced the 2021 dollar limits for various benefits and compensation levels for retirement plans and IRAs. There are incremental changes but nonetheless worth bookmarking.

 

The contributions and retirement benefits for qualified retirement plans and individuals. Retirement Arrangements (IRAs) are subject to certain limits that are adjusted by the Secretary of the Treasury annually subject to cost-of-living. Highlighted below are the various 2020 and 2021 limits that impact IRA and retirement plans.

 

Compensation Limits

 

 

 

2020

2021

Compensation Limit

285,000$$290,000

Defined Benefit §415 Limit

$230,000

$230,000

Defined Contribution §415 Limit

$57,000$57,000

Key Employee Officer

$185,000$185,000

Highly Compensated Employee

$130,000$130,000

Governmental. Plan Compensation

Limit

$425,000$435,000

ESOP §409(o) Limits

$1,150,000

$230,000

$1,165,000

$230,000

 

 

 

Deferral and Catch-up Contribution Limits

 

 

2020

2021

401(k), 403(b), 457(b) Nan Deferral. Limi

$19,500$19,500

401(k), 403(b), Governmental. 457(b) Catch-up Limi

$6,500

$6,500

SIMPLE Plan Deferral Limi

$13,500$13,500

Key Employee Officer

$185,000$185,000

SIMPLE Plan Catch-up Limit

$3,000$3,000

 


IRA Limits

 

The limit on contributions to a traditional. or Roth IRA will remain unchanged in 2021 at $6,000. The limit that applies to IRA catch-up contributions (contributions for individuals age 50 and older) remains at $1,000.

 

Social Security

 

The Social. Security Administration (SSA) announced an increase in the taxable wage base (TWB) for 2021 to $142,800 (was $137,700 in 2020). Workers pay Social. Security tax on wages up to the TWB and some retirement plans use the TWB when allocating contributions or calculating benefits.

 

HSA Contribution Limits

 

Although not a formal. retirement plan, health savings accounts (HSA) often factor into retirement savings. The IRS announced the following 2021 limits. These apply to individuals under a high-deductible-health-plan (HDHP). The minimum deductibles and maximum out-of-pocket expenses the IRS uses to define HDHPs are outlined below, as well.

 

HSA Contribution Limits

 

LimitIndividualFamily

 

 

2020

2021

2020

2021

HSA Contribution Limits

$19,500$19,500$7,100$7,200

Minimum Deductible for HDHPs

$6,500

$6,500

$2,800

$2,800

Maximum Out-of-Pocket Expense

$6,500$6,500$2,800$2,800

 

Resource:

 

 

 

 

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right for you? Please contact our team at 360PEO (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for the latest news updates.

 

The subject matter in this communication is educational only and not rendering legal, accounting, investment advice, or tax advice. You should consult with appropriate counsel or other professionals on all matters pertaining to legal, tax, investment, or accounting obligations and requirements.

 

 

 

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President Issues Health Care Plan Executive Order

President Issues Health Care Plan Executive Order

On Sept. 24, 2020, President Donald Trump issued an executive order outlining his health care plan, called the America First Health Care Plan. This Legal Update video explains further.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

BREAKING: HIT and Cadillac Tax Repealed

Congress has voted to fully repeal the Cadillac Tax and Health Insurance Tax  effective January 1, 2021. This means the Health Insurance Tax will still be in place for 2020 and will be gone in 2021.
 
Both unpopular taxes with bipartisan approval delayed the Cadillac Tax but put the Health Insurance Tax(HIT) back in for 2020 earlier this summer. See Cadillac Tax Out Health Insurance Tax (HIT) Back In. Below are summaries of these two taxes that are now fully repealed.
 

Whats is the Health Insurance Tax (HIT)?

Health Insurance Tax: This tax included in the Affordable Care Act (ACA) increased the cost of health care coverage for consumers and employers in every state. The ACA imposed a new sales tax on health insurance that started at $8 billion in 2014, increased to $14.3 billion by 2018, and continued to increase each year.
 
The HIT costing an estimated 2.5%-3% added surcharge or an estimated $500/family annually and $241 for Seniors. Website Stop The Hit calculates $5,000 as the average tax for a 10 man small business for example.
 

Whats is the Cadillac Tax?

The Cadillac Tax was to take effect in 2022 and had been twice delayed since its original inception scheduled for Jan 2014. This tax called for a 40% excise tax on the amount of the aggregate monthly premium of each primary insured individual that exceeds the year’s applicable dollar limit, which will be adjusted annually to the Consumer Price Index plus 1%.
 
The 40% excise tax applies to the cost of employer health plan coverage exceeding certain threshold amounts, which were originally set for 2018 at $10,200 for individuals or $27,500 for families.
 
 
Originally, the Cadillac Tax was pushed back by the behest of Unions to 2018 from the original proposed 2014 date. Most Unions with generous health care packages would not be complaint within that time frame. For average Gold Plans in regions such as NY, the widely unpopular Cadilac Tax would have been felt.
 
Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

PPP Flexibility Act Signed

PPP Flexibility Act Signed

On Friday, June 5, President Trump signed the Paycheck Protection Program (PPP) Flexibility Act, clearing the way for more flexibility and forgiveness of the loans made through the PPP. Originally these loans, which were part of the CARES Act, were provided to help business owners cover payroll costs, rent, and utilities.

The newly enacted legislation states that:

  • Business owners now have 24 weeks to spend funds (up from eight weeks)
  • Business owners only need to spend 60% of the loan on payroll costs (down from 75%)
  • The covered period of the loan now ends December 31 instead of June 30
  • Business owners won’t have to make employer payroll tax payments through the end of 2020
  • The business will not lose any loan forgiveness eligibility if it can show that some employees declined to return to their jobs or the pre-pandemic headcount is no longer required
  • The payback period for new loan applicants has been extended from two years to a minimum of five for those not seeking, or who are ineligible, for forgiveness

If you’d like to find out more about how you can get better benefits so your employees use them when they need to, we’d like to show you how. Please contact us using form below or info@360peo.com or 855-667-4621.

The information provided on this website is intended for informational purposes only.  360PEO does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

HSA 2023 Dollar Limits

HSA 2021 Limits

The IRS has released the 2021  Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

New HSA 2021 limits are as follows:

 

2021

2020

HSA Annual Contribution Limit
$3,600;  $7,200
$3,550 – Single; $7,100 – Family
HDHP Minimum Annual Deductible
$1,400;  $2,800
$1,400 – Single; $2,800 – Family
HDHP Out-of-Pocket Maximum
$7,000;  $14,000
$6,900 – Single; $13,800 – Family
Age 55+ Catch-Up Provision
$1,000;  $2,000
$1,000- Single; $2,000 – Husband/Wife

Age 55 Catch Up Contribution

As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of the year, you can contribute an additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute an additional $1,000. A savvy strategy for high-income earners is to invest the money in your HSA for the long haul. Once you’re 65, you can take out tax-free distributions to cover Medicare premiums. If you withdraw money at that point for non-medical uses, you pay the same tax as you would on withdrawals from a pretax 401(k). But you can also take money out tax-free to reimburse yourself for prior years’ out-of-pocket medical expenses if you have the old receipts.


COVId-19 Update: 

You can even use an HSA to save on a typical trip to the CVS. Thanks to a tax relief provision tucked in the last Covid-19 stimulus package, you can use the money you stash in an HSA or FSA (more on those later) for over-the-counter medications like Tylenol or Flonase as well as menstrual products like tampons and pads. That reverses Obamacare restrictions on OTC meds requiring a doctor’s prescription for them to be eligible for reimbursement.

 

HSA/HDHP Market Growth

HSA holders own the assets in the accounts and can build up substantial sums over time.  Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.

FSA Store

HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.

  • The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
  • 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
  •  14% of all workers in the private sector have access to a Health Savings Account acc. to the Bureau of Labor Statistics.
  • States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois, and Minnesota.

HSA Advantages:

  • Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
  • Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
  • Tax-Free Money allowed for non-traditional Medical coverage– As per IRS Publication 502, unused money can be used for dental, vision, Lasik eye surgery, acupuncture, yoga, infertility, etc.  Popular Examples
  • Portability – The funds belong to you, so you keep the funds if you change jobs or retire.

Our overall experience with HSAs has been positive when employer funding is at a minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money).  Traditional plans trend of higher copays and new in-network deductibles has also led to the popularity of an HSA.

Next Steps

Plan sponsors should update payroll and plan administration systems for the 2021 cost-of-living adjustments and should incorporate the new limits in relevant participant communications, such as open enrollment and communication materials, plan documents, and summary plan descriptions.

RESOURCE:

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for the latest news updates.

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6 Advantages of a PEO during COVID-19

6 Advantages of a PEO during COVID-19

6 Advantages of a PEO during COVID-19

As COVID-19 unfolds, the importance of a PEO for a Small Business becomes evident. How can you protect your employees while also managing costs?  Here are examples of how our PEO clients have benefited.

 1. Rapid Law Changes

With recent CARES Act and FFCRA(Families First Coronavirus Response Act) to help struggling businesses, overwhelming info and regulations have mounted for the small business owner. Who is eligible for benefits? Tax credits? Furloughs and COBRA? Is their business Essential? Paid Sick Leave eligibility and additional tax credit entitlement?

PEOs provide a full team of experts who anxiously awaited the legislation, final rulings, and updates on all the Acts. They spend countless hours diving into legal jargon to answer business owners’ questions. Then, PEOs work alongside organizations to implement processes that assist in keeping the business compliant. They also help employees through the difficult time, with the livelihood of the business always in mind.

2. PEOs help with Paycheck Protection Program (PPP) loans through the CARES Act

Lenders are asking for historical payroll data and tax reports quickly produced by a PEO’s HRIS System. Many small businesses without HR help find these systems financially draining. Example: Needed 940/941 reporting is issued which can be sent to SBA Lender.  Also, several leading  PEO’s have supported clients with NYS Shared Loans Program.

Working with clients to understand options.

 3. Payroll Burden

Payroll administration is now a nightmare. Tracking the FFCRA emergency sick leave and expanded FMLA separately from regular sick and FMLA leave has thrown a wrench in many payroll processors’ systems. Add on any furloughed or terminated employee reporting and tracking, and now the job has doubled.

Instead, our PEO Clientsy are spending their time on mission-critical work that could make or break the business. Additionally, their payroll is processed by professionals who have the time and expertise to know the nuances of payroll and payroll tax laws with back up teams of professionals in place.

 4. Staffing Needs – On-Boarding and Terminations 

A minimum 75% of PPP loans must be spent on staffing costs.  Companies that had previously furloughed or terminated employees find they need to hire employees back. This comes with additional paperwork and many employee questions, such as whether benefits wait periods start over. 

Conversely, when businesses do need to furlough or terminate employees, the PEO is a great guide for compliance. The layoff process, COBRA,  paperwork including givernement reporting are supported. 

5. HR Excellence

Partnering with a PEO is much like gaining access to a full-service HR division, with a team of HR experts who are up-to-date with new and changing employment laws and able to identify ways to streamline your HR.

According to a report conducted by the National Association of Professional Employer Organizations (NAPEO), PEOs provide access to more HR services at a cost that is close to $450 lower per employee, compared to companies that manage their HR services in-house. 

 Studies show that businesses in a PEO arrangement grow 7-9 percent faster, have 10-14 percent lower turnover, and are 50 percent less likely to go out of business.

 6. Affordable and Better Benefits

By joining a large group risk-pool a a PEO can help employers gain access to high quality employee benefits, such as health insurance options with stable and affordable rates. Due to costs, small businesses often find high-quality employee benefits out of reach.  The savings on health insurance alone can pay for the PEO itself.  

If you’re interested in hearing more about the advantages of partnering with a PEO, we’d love to talk to you. Fill out the form below or email info@medicalsolutionscorp.com for a FREE Consultation Today!

The information provided on this website is intended for informational purposes only.  Millennium Medical Solutions Corp. does not offer legal or medical guidance.  Those with legal or medical questions should seek appropriate assistance from a licensed professional.  Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

Coronavirus Preparedness Plan

Coronavirus Preparedness Plan

Coronavirus Preparedness Plan

As we watch, wait and see the evolution of this Corona Virus outbreak, it is important that employers plan. This is not a situation where you want to panic should this hit your business.

What we know about the virus

Coronaviruses are an extremely common cause of colds and other upper respiratory infections. The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people — especially the very young, elderly, or people who have a weakened immune system — may develop a more serious infection, such as bronchitis or pneumonia.

Should you worry about catching this virus?

Unless you’ve been in close contact with someone who has the coronavirus — right now, this typically means a traveler from Wuhan, China who actually has the virus — you’re likely to be safe. In the US, for example, all five cases of the virus were recent travelers to Wuhan. The CDC maintains the risk is low to Americans, however, “we need to be preparing as if this is a pandemic, but I continue to hope that it is not,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

How can I protect myself? 

Much like prevention of the spread of any other infectious disease, basic hygiene principles are key to curbing the spread of this virus.

  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol if soap and water are not available.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

Be mindful of:

  • Employee wellbeing. Monitor updates from public health officials and governments and keep employees informed and educated about the outbreak and any steps being taken to safeguard their health. Encourage employees to stay home when sick and telecommute if the outbreak worsens.
  • Travel policies. As of Monday, January 27th, the CDC has issued a stronger warning about travel, urging Americans to reconsider travel anywhere in China, issuing a stronger level 4 warning for the specific province where Wuhan is located, stating: “Do not travel to Hubei province, China” due to the coronavirus outbreak.
    The Centers for Disease Control and Prevention urges people to seek medical care right away if they had traveled to Wuhan in the past two weeks and develop a fever, cough or trouble breathing. It says older adults and people with underlying health conditions may be most at risk for severe illness from the virus.
  • Potential supply chain interruption. Identify operational and/or revenue impacts from potential disruptions to key suppliers and vendors. Also consider the possibility of sourcing good or parts from alternative suppliers.
  • Insurance coverage. Review insurance policies, prepare for potential claims, and consult your broker if you have questions.

Resource:

Please contact us for further information or if you need assistance creating a workable plan.

Contact us at (855) 667-4621 or email us at info@360peo.com

Learn more about

Liability Protection     •     Employee Benefits     •     HR Consulting

 

Breaking: HIT and Cadillac Tax repealed

Breaking: HIT and Cadillac Tax repealed

BREAKING: HIT and Cadillac Tax Repealed

Congress has voted to fully repeal the Cadillac Tax and Health Insurance Tax  effective January 1, 2021. This means the Health Insurance Tax will still be in place for 2020 and will be gone in 2021.
 
Both unpopular taxes with bipartisan approval delayed the Cadillac Tax but put the Health Insurance Tax(HIT) back in for 2020 earlier this summer. See Cadillac Tax Out Health Insurance Tax (HIT) Back In. Below are summaries of these two taxes that are now fully repealed.
 

Whats is the Health Insurance Tax (HIT)?

Health Insurance Tax: This tax included in the Affordable Care Act (ACA) increased the cost of health care coverage for consumers and employers in every state. The ACA imposed a new sales tax on health insurance that started at $8 billion in 2014, increased to $14.3 billion by 2018, and continued to increase each year.
 
The HIT costing an estimated 2.5%-3% added surcharge or an estimated $500/family annually and $241 for Seniors. Website Stop The Hit calculates $5,000 as the average tax for a 10 man small business for example.
 

Whats is the Cadillac Tax?

The Cadillac Tax was to take effect in 2022 and had been twice delayed since its original inception scheduled for Jan 2014. This tax called for a 40% excise tax on the amount of the aggregate monthly premium of each primary insured individual that exceeds the year’s applicable dollar limit, which will be adjusted annually to the Consumer Price Index plus 1%.
 
The 40% excise tax applies to the cost of employer health plan coverage exceeding certain threshold amounts, which were originally set for 2018 at $10,200 for individuals or $27,500 for families.
 
 
Originally, the Cadillac Tax was pushed back by the behest of Unions to 2018 from the original proposed 2014 date. Most Unions with generous health care packages would not be complaint within that time frame. For average Gold Plans in regions such as NY, the widely unpopular Cadilac Tax would have been felt.
 
Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@360.com.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

BREAKING: HIT and Cadillac Tax Repealed

Congress has voted to fully repeal the Cadillac Tax and Health Insurance Tax  effective January 1, 2021. This means the Health Insurance Tax will still be in place for 2020 and will be gone in 2021.
 
Both unpopular taxes with bipartisan approval delayed the Cadillac Tax but put the Health Insurance Tax(HIT) back in for 2020 earlier this summer. See Cadillac Tax Out Health Insurance Tax (HIT) Back In. Below are summaries of these two taxes that are now fully repealed.
 

Whats is the Health Insurance Tax (HIT)?

Health Insurance Tax: This tax included in the Affordable Care Act (ACA) increased the cost of health care coverage for consumers and employers in every state. The ACA imposed a new sales tax on health insurance that started at $8 billion in 2014, increased to $14.3 billion by 2018, and continued to increase each year.
 
The HIT costing an estimated 2.5%-3% added surcharge or an estimated $500/family annually and $241 for Seniors. Website Stop The Hit calculates $5,000 as the average tax for a 10 man small business for example.
 

Whats is the Cadillac Tax?

The Cadillac Tax was to take effect in 2022 and had been twice delayed since its original inception scheduled for Jan 2014. This tax called for a 40% excise tax on the amount of the aggregate monthly premium of each primary insured individual that exceeds the year’s applicable dollar limit, which will be adjusted annually to the Consumer Price Index plus 1%.
 
The 40% excise tax applies to the cost of employer health plan coverage exceeding certain threshold amounts, which were originally set for 2018 at $10,200 for individuals or $27,500 for families.
 
 
Originally, the Cadillac Tax was pushed back by the behest of Unions to 2018 from the original proposed 2014 date. Most Unions with generous health care packages would not be complaint within that time frame. For average Gold Plans in regions such as NY, the widely unpopular Cadilac Tax would have been felt.
 
Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

Breaking: ACA News in Texas v. U.S. Case

Breaking: ACA News in Texas v. U.S. Case

A Texas appeals court ruled yesterday that the Obamacare individual mandate unconstitutional and sends law back to lower court. 

The US of Appeals  issued its decision in the Texas v. United States case. The case challenged the constitutionality of the ACA’s individual mandate in light of the Tax Cuts and Jobs Act of 2017, which zeroed out the individual mandate penalty. The appellate court was reviewing the lower court’s ruling that found that the individual mandate, with no accompanying tax penalty, is unconstitutional and that the individual mandate is such an essential part of the ACA that the ACA cannot function without the individual mandate in place.

 

In the appellate court’s ruling, it agreed that the individual mandate is unconstitutional because it can no longer be read as a tax, and there is no other constitutional provision that justifies this exercise of congressional power. However, when reviewing whether the individual mandate could be separated from the rest of the ACA, the appellate court sent that question back to the district court to provide additional analysis of the provisions of the ACA as they currently exist that was not provided in the lower court’s previous decision.

This ruling is not final and is expected to be engaged in appeals for the next several months, which will likely culminate in a hearing before the Supreme Court. This means that the ACA continues to be the law of the land and compliance with the ACA is still being enforced. Coverage for the 2020 plan year remains unaffected by the ruling.

If you have questions about the impact of this ruling, contact info@360peo.com.

Learn how our PEO Partnership can help your group please contact us at info@360peo.com or (855)667-4621.

Put You & Your Employees in Good Hands

Get In Touch

For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP. 

2018 Medicare Infographic

2018 Medicare Infographic

What You Need to Know About Medicare 2018 Infographic

2018 medicare InfographicThis timely infographic walks seniors through the differences between traditional Medicare and Medicare Advantage vs. Supplement Plans + a helpful plain English glossary.

Open Enrollment ends Dec 7, 2017, for Jan 1, 2018 effective date. Enroll by phone advantage at (855) 667-4621.

2018 Medicare Open Enrollment is Here

We are certified and appointed to sell senior plans with leading health insurers in order to help people in New York currently enrolled in Medicare or those who are aging into Medicare (turning 65) with a wide variety of options. Some of these are Medicare Advantage (HMO, PPO), supplement plans, and Part “D” prescription plans (PDP,s).

There are also some special enrollment periods (SEP) available to individuals under certain conditions. The Annual Enrollment Period (AEP) for Medicare is October 15 to December 7 this year. Those currently on Medicare can shop around and switch their plans at this time. The initial enrollment period (IEP) of 7 months. This is from 3 months prior to your 65th birthday, the month of your birthday, and the 3 months following your birth month.
It is wise to contact an expert to help you find the coverage that best suits you during these enrollment periods. You can call or email us at any time for comprehensive, “no pressure” advice.

Resource:

Medicare Supplement Plans

Medicare Advantage 

Getting Extra Help with Medicare Expenses

Medicare FAQ

Dates to Remember

October 1

You can start getting plan information for 2018 premiums and benefits.

October 15 — December 7

This is the Annual Election Period (AEP). During this time, you can make changes to your existing Medicare health or prescription drug plan or select a new plan for 2018.

January 1 — February 14

This is the Medicare Advantage Disenrollment Period. During this time, you can prospectively disenroll from your Medicare Advantage (MA) plan and return to Original Medicare.

If you are turning 65:

– If you aren’t getting Social Security (for instance, because you are still working), you will need to sign up for Medicare benefits. You should contact Social Security three months before you turn age 65.
– You can enroll in a Medicare plan starting three months before the month of your 65th birthday, the month of your birthday, and for up to three months after your 65th birthday, for a total period of seven months.

 Contact Us Now    Learn how our Agency is helping businesses thrive in today’s economy. Please contact us at info@360peo.com or (855)667-4621.