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R&R Insurance Blog

Employee Benefit Plan Limits for 2019

Posted by the knowledge brokers

ComplianceMany employee benefits are subject to annual dollar limits that are periodically updated for inflation, such as HSAs, health FSAs, and transportation fringe benefit plans. This Compliance Overview includes a chart of the inflation-adjusted limits for 2019. Although some of the limits will remain the same, many of the limits increase for 2019.

The IRS typically announces the dollar limits that will apply for the next calendar year well in advance of the beginning of that year to give employers time to update their plan designs and make sure their plan administration will be consistent with the new limits.

Contact a Knowledge Broker for more information.

Topics: Employee Benefits, Compliance

IRS Issues Letter 5699 to Employers that are Non-compliant with ACA Reporting

Posted by Pete Frittitta

reportingThe Internal Revenue Service (IRS) has been sending Letter 5699 to employers that have not complied with their Affordable Care Act (ACA) reporting requirements under Internal Revenue Code Section 6056 for the 2015 calendar year.

Letter 5699, Request for Employer Reporting of Offers of Health Insurance Coverage (Forms 1094-C and 1095-C), requests missing information from applicable large employers (ALEs) that were required to report under Section 6056, but failed to file Forms 1094-C and 1095-C with the IRS. The IRS identifies potentially non-compliant ALEs based on their Form W-2 total employee count reported for the 2015 calendar year.

The IRS began issuing Letter 226-J to certain ALEs that filed Forms 1094-C and 1095-C to inform them of their potential liability for an employer shared responsibility penalty for the 2015 calendar year. Similarly, the IRS has been issuing Letter 5699 as its enforcement mechanism to identify and assess penalties against ALEs that failed to file Forms 1094-C and 1095-C for the 2015 calendar year.

Employers who receive a Letter 5699 should respond to the IRS within the appropriate time frame. When responding to Letter 5699, employers should provide all appropriate information requested by the IRS, including any Forms 1094-C and 1095-C that are due. Keep in mind that penalties may apply for any failures to file with the IRS by required deadlines. The IRS will use information provided in response to Letter 5699 to identify non-compliant ALEs and assess any penalties that may be owed.

For more information regarding Letter 5699 and related ACA reporting penalties, click here.

To learn more about Letter 226-J, you can refer to our previous blog here.

Source: Zywave

Topics: Compliance

DOL Finalizes Rule to Expand Association Health Plans

Posted by R&R Insurance

Association Health PlansOn June 19, 2018, the Department of Labor (DOL) released a final rule that gives small businesses more freedom to join together as a single group to purchase health insurance in the large group market or to self-insure. These benefit arrangements are called association health plans (AHPs). The final rule allows working owners without other employees, such as sole proprietors and other self-employed individuals, to join AHPs.

The final rule allows employers to join together to form an AHP that is a single ERISA plan if either of the following requirements is satisfied:

  • The employers are in the same trade, industry, line of business or profession; or
  • The employers have a principal place of business within a region that does not exceed boundaries of the same state or the same metropolitan area (even if the metropolitan area includes more than one state).


Most AHPs will not be subject to the Affordable Care Act’s requirement to include Essential Health Benefits (EHB), which requires small group plans to cover a core set of 10 major items and services, such as mental health care, maternity and newborn care, prescription drugs and emergency services. Most AHPs will also be exempt from the ACA’s rating restrictions for the small group market, which means that AHPs may base premiums on factors such as age, industry and gender. The final rule requires AHPs to comply with certain consumer protections and anti-discrimination protections that apply to the large group market (learn more).

R&R will continue to keep you informed as we monitor developing guidance regarding AHPs and other benefits matters at the federal and state levels. For a more complete understanding of the new AHP rule, click here to read more.

Topics: Compliance, benefits

Wisconsin's ACA Section 1332 Waiver Application Is Officially Complete

Posted by Pete Frittitta

On May 9, 2018, the Departments of Health and Human Service and the Treasury notified officials in Wisconsin that their application for a state innovation waiver under Section 1332 of the Affordable Care Act (ACA) was complete. The Departments will accept public comment on the waiver application until June 8, 2018 and approve or deny the application within 180 days.

Wisconsin proposes to develop and implement a state-based reinsurance program—the Wisconsin Healthcare Stability Plan (WIHSP)—for its individual insurance market. WIHSP, if approved, would begin in the 2019 plan year and reduce premiums by 10.6 percent (relative to what premiums would have been in the absence of the waiver). Wisconsin estimates a federal pass-through rate of 83 percent. Of the overall $200 million program, the federal government is expected to contribute about $166 million and state funds are expected to account for about $34 million.

Stay tuned as developments progress.

Topics: Compliance

What You Need to Know About Premium Refund Checks

Posted by Pete Frittitta

erisa advisoryYou have the opportunity to earn a premium refund on your level-funded plan but do you know what to do with it once you get it? Or maybe you’ve already received one - did you know that there are compliance rules to follow to disburse any employee share of that refund within 90 days?

In most simple terms, if employees pay a portion of health care premiums, then they are entitled to a prorated share of the premium refund. Additionally, you must distribute the appropriate funds within 90 days of receiving the refund check.

There are some interpretations being expressed in the consulting community that would suggest a very simple option exists such as “give every employee the same amount.” We strongly discourage this as it relies on comments from the U.S. Department of Labor (DOL) that contradict other guidance by the DOL. It clearly is not supported.

An employer can apply the entire refund check amount toward reducing employee contributions. However, this only eliminates the need to calculate the “split” between the employees and the employer. Unless the employer has paid 100% of the premiums, employers will still need to calculate the appropriate share of the refund for each employee prorated according to the amount they contributed.

There are basically three compliance options available to employers. If you are not familiar with the compliance options that are available to you, contact an R&R Benefits Knowledge Broker to learn more.

Topics: Employee Benefits, Compliance

Spending Resolution Affects ACA Taxes

Posted by Terry Frett, CEBS, ChHC, CLU, CPCU, REBC, RHU

Gavel with cash.jpgOn Monday January 22, 2018, Congress passed HR195 to extend funding for the government through February 8, 2018.  President Trump signed the legislation into law Monday night.  Although this new law was crafted to continue funding the government, it did contain 3 specific items impacting employer sponsored health insurance plans:

  • Health Insurance Tax
    • Presently, insured health plans include a premium tax that adds over 2% to the premium rate. This tax is part of the Affordable Care Act.  With the passage of HR195, the Health Insurance Tax will be suspended for 2019.
  • Cadillac Tax
    • The Affordable Care Act contained what is often referred to as the “Cadillac Tax”. The tax was originally scheduled to be implemented in 2018.  It would result in a 40% excise tax for health insurance plans with annual costs in excess of $10,200 for single coverage and $27,500 for family coverage.  The tax would be paid by the plan sponsor.  This tax was delayed to 2020 and now, as a result of HR195, it is delayed until 2022.
  • Medical Device Tax
    • Manufacturers of medical devices were set to be subjected to a 2.3% tax on their products. Again, this tax was part of the Affordable Care Act.  The passage of HR195 delays the start of this tax for 2 more years.

The new tax law (signed on December 22, 2017) eliminated the individual health insurance mandate penalty starting in 2019.  The employer mandate for Applicable Large Employers (generally companies with 50 or more full-time equivalent employees) and the 1095 reporting continues unchanged.

Employers should be aware of the evolving applicability of existing ACA taxes and fees so that they know how the ACA affects their bottom lines. R&R Insurance Services will continue to keep you informed of changes.

Read here for a more comprehensive list of these current updates. If you have any questions, feel free to contact a Knowledge Broker at 800.566.7007.

Topics: ACA, Compliance

New Audit Tool Now Available Through R&R's Risk Management Center

Posted by R&R Insurance

Audit-Track.jpgIs your organization looking for a way to streamline the audit process for safety and compliance? Do you struggle to create and maintain audits, surveys or questionnaires?

R&R’s Risk Management Center offers an easy-to-use, web-based solution to help manage the audit process from start to finish.

The Audit Track® provides your organization with the tools you need to proactively manage workplace safety, employee training, IIPP/APP safety program development, and OSHA compliance tracking, reporting and analysis. The tool also allows managers to oversee safety audit, inspection and compliance reporting needs, as well as confirmation that all tasks are assigned, completed and recorded – ensuring your workplace remains safe and compliant.

Completely customizable to your organization, the Audit Track® allows you to:

  • Create custom audits for your organization or department
  • Deploy in the field on any major mobile device
  • Assign to any employee and track tasks, activities and results
  • Access summary and detailed reports based on your criteria
  • Track, achieve and demonstrate regulatory compliance
  • Target and resolve revealed issues before they become incidents
  • Proactively manage your workplace
  • Set field audits and surveys to your unique reoccurrence
  • Make automated auditing an integral part of your safety strategy
  • Keep all Safety Audits, Inspections, Self Assessments and other workplace checklists up-to-date

For more information on R&R’s Risk Management Center and the Audit Track®, visit www.myknowledgebroker.com/RMC or email Safety@rrins.com.

Topics: audit, Safety, Compliance, OSHA Compliance, Risk Management Center

Phase II HIPAA Audits Occurring in 2015

Posted by the knowledge brokers

HiPAA 2The Office of Civil Rights (OCR) has proposed to ramp up their Phase II HIPAA audits at some point in 2015. Unlike the initial pilot Phase I audits, the second round will require compliance from the chosen health care account, as well as be expanded to include their “Business Associates.” Business Associates being subcontractors of health care organizations that have business agreements with the selected entity.

These audits will affect between 550-800 covered entities and their associated business partners chosen at random through the National Provider Identifier database.

What will the OCR be looking for?

  • Risk analysis and risk management policies
  • Content and timeliness of breach notifications
  • Notice of privacy practices
  • Individual access
  • Training procedures
  • Device and media controls
  • Transmission security (Encryption)

The OCR will use the Phase II Audit findings to identify technical assistance that it should develop for covered entities and business associates. In circumstances where an audit reveals a serious compliance concern, OCR may initiate a compliance review of the audited organization that could lead to civil money penalties.

If you are a health care organization or have a Business Agreement with a health care organization, this may be a good time to review your Network Security Liability coverage with your insurance agent.

 

Contact our knowledge brokers for more information!

Topics: Healthcare, HIPAA, audit, Compliance, health care, HIPAA audit