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February 2017 Benefits Buzz

Benefits Buzz - February 2017
This edition of Benefits Buzz includes:
  • An overview of the 21st Century Cures Act (Act)
  • The highlights of the Notice of Benefit and Payment Parameters for 2018
  • Developments with Republican lawmakers proposed budget resolution that would repeal parts of the Affordable Care Act (ACA)
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Department of Labor Establishes New Rule

On May 18, 2016, the Department of Labor (DOL) issued a release with a final ruling regarding the overtime wage payment qualifications under the Fair Labor Standards Act (FLSA). The final rule increases the salary an employee must be paid. The required salary level has increased to $47,476 per year and is updated every three years. Employers must comply with the new rule by December 1, 2016. For more information sign up for the DOL’s Webinar by clicking here Click here to download our Compliance Bulletin to learn more about the DOL’s new rule.

Religious Accommodations Expanded Under The Contraceptive Mandate

All_Religious_IconsOn Aug. 27, 2014, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (the Departments) collectively published two separate rules in response to recent U.S. Supreme Court decisions on the contraceptive mandate under the Affordable Care Act (ACA). These rules address both nonprofit and closely held for-profit entities:
  • An interim final rule maintains the existing accommodation for certain religious nonprofit organizations, and also creates an additional pathway for eligible organizations to provide notice of their objection to covering contraceptive services.
  • A proposed rule would extend the same accommodation that is available to nonprofit religious organizations to certain closely held for-profit companies.
The ACA’s Contraceptive Coverage Mandate Effective for plan years beginning on or after Aug. 1, 2012, the ACA requires non-grandfathered health plans to cover certain women’s preventive health services without cost-sharing (such as a co-pay, co-insurance or a deductible). Under these rules, plans must cover all FDA-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity. However, special contraceptive coverage rules apply for certain religious employers and organizations. These rules exempt churches and other houses of worship from the ACA’s requirement to cover contraceptives. For other church-affiliated institutions that object to contraceptive coverage (such as schools, charities, hospitals and universities), these rules establish an accommodations approach. Exemption for Non-profit Religious Employers In July 2013, the Departments published final rules providing an exemption from the contraceptive coverage requirement for group health plans of certain non-profit religious employers (such as churches and other houses of worship). Under this exemption, eligible employers offering health coverage may decide whether or not to cover contraceptive services, consistent with their beliefs. To qualify for the exemption, the employer must be a non-profit entity that is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code. This definition primarily includes churches, other houses of worship and their affiliated organizations.  FULL ARTICLE


sunscreen-shutterstock-537x366By now the importance of adequate skin protection is widely known. Skin cancer is the most common cancer in the United States, and the number of Americans who have had skin cancer at some point in the last three decades is estimated to be higher than the number for all other cancers combined. Most cases of melanoma, the deadliest kind of skin cancer, are caused by exposure to ultraviolet (UV) light. The sun’s UV rays can damage your skin in as little as 15 minutes. While there are several steps you can take to limit your exposure to the sun, proper sunscreen selection and application is critical. Sunscreen Labeling and Differences All sunscreen comes labeled with a Sun Protection Factor, or SPF, which is the measure of a sunscreen’s ability to prevent ultraviolet B (UVB) light from damaging the skin. SPF 15 filters out approximately 93 percent of all incoming UVB rays. SPF 30 keeps out 97 percent and SPF 50 keeps out 98 percent. Some sunscreen also protects against Ultraviolet A light, as well as UVB. This kind of sunscreen is called broad-spectrum. While you can find information online about calculating sun exposure times, keep in mind that duration equations are not always accurate and SPF numbers are not supposed to help you determine the amount of time you can remain in the sun after initial application. Recent changes mandated by the Food and Drug Administration (FDA) have made sunscreen selection a lot easier. Under the new rules, sunscreen can only claim to reduce the risk of skin cancer and early skin aging if it is both broad-spectrum and has an SPF of 15 or higher. Sunscreen that is not broad-spectrum or has an SPF of less than 15 can only claim to prevent sunburn and must include a warning stating it cannot prevent skin cancer or early aging. Sunscreen products also can no longer claim to be waterproof, only water-resistant, and labels must note a time limit of either 40 or 80 minutes before the sunscreen is ineffective. Sunscreen Recommendations While the FDA changes have cleared up confusion regarding the various types of sunscreen, how do you know what type is right for you? The answer can be found in sunscreen recommendations made by the American Academy of Dermatologists. Their suggestions include: READ FULL ARTICLE

Repaying Exchange Subsidy Overpayments

  money-addiction   Repaying Exchange Subsidy Overpayments   The Affordable Care Act (ACA) created health insurance subsidies, in the form of premium tax credits and cost-sharing reductions, to help eligible individuals and families purchase health insurance through an Exchange. By reducing a taxpayer’s out-of-pocket premium costs, the subsidies are designed to make coverage through an Exchange more affordable.   Subsidies became available beginning in 2014, at the same time the Exchanges became operational. The Exchange open enrollment period for the 2014 plan year ended on March 31, 2014. The 2015 annual open enrollment period will begin on Nov. 15, 2014.   If an enrollee is eligible for a premium tax credit, advance payments of the credit will be made directly to the insurance company on the family’s behalf. At the end of the year, the advance payments must be reconciled against the amount of the family’s actual premium tax credit, as calculated on the family’s federal income tax return.   On May 23, 2012, the Internal Revenue Service (IRS) published final regulations on the ACA’s health insurance subsidies. These regulations provide detailed rules for reconciling advance payments of the premium tax credit.   Overview of the Exchange Health Insurance Subsidies   There are two federal health insurance subsidies available with respect to coverage through an Exchange: premium tax credits and cost-sharing reductions. Both of these subsidies vary in amount based on the taxpayer’s household income and reduce the out-of-pocket costs of health insurance for the insured.  
  • Premium tax credits are available for people with somewhat higher incomes (up to 400 percent of the federal poverty level (FPL)), and they reduce out-of-pocket premium costs for the taxpayer.
  • Reduced cost-sharing is available for people with lower incomes (up to 250 percent of the FPL). Through cost-sharing reductions, these individuals will be eligible to enroll in plans with higher actuarial values and have the plan, on average, pay a greater share of covered benefits. This means that coverage for these individuals will have lower out-of-pocket costs at the point of service (for example, lower deductibles and copayments).
  Subsidies are calculated on the taxpayer’s return using the taxpayer’s household income and family size for the taxable year. For purposes of determining eligibility for these subsidies, and the amount of any subsidy available, household income is determined using the taxpayer’s federal income tax return for that year. However, because these subsidies are provided when the individual purchases insurance, the Exchanges will generally have to determine household income well before the individual files his or her tax return for that year. CLICK FOR FULL ARTICLE

Live Well, Work Well September 2014

Low-impact Exercise
While most people desire the health benefits of exercise, not all exercise can or should be performed by everyone. For many people, health conditions or long-term injuries prevent them from taking up some of the more demanding forms of exercise. If you fall into one of those categories, low-impact exercise may be what you’re looking for. Designed to limit stress on the body, low-impact exercise can still be intensive enough to provide cardiovascular and musculoskeletal benefits. You don’t need to be a mountain climber or marathoner to obtain rewarding levels of personal fitness, but you do need regular exercise in order to maintain your health and well-being. Consider the following forms of exercise as a way to meet your fitness goals:
  • Walking. The simplest form of exercise is still one of the best. This low-cost, low-stress workout will benefit your body and mind without taking a toll on your body. Just make sure your shoes are up to the distance and terrain challenges.
  • Swimming. Swimming is one of the most grueling exercises out there. However, it can be done by almost anyone since its demands on the body’s joints are practically non-existent.
  • Elliptical trainer. This stationary exercise machine provides a full-body cardio workout while limiting impact on joints.
  • Cycling. Whether stationary or in motion, pedaling a bike burns major calories without punishing your body.CLICK FOR FULL ARTICLE

HR Brief– September 2014

“Ban the Box” Takes Criminal History off Job Applications

“Ban the box” refers to legislation being passed by many cities and counties that prohibits criminal history questions on job applications. The “box” is the section on job applications where applicants are asked whether they have had any criminal convictions. Ban-the-box laws do not prevent an employer from performing a background check after an interview or conditional offer of employment.   Twelve states have also passed ban-the-box legislation, most recently including California, Delaware, Illinois, Maryland, Minnesota, Nebraska and Rhode Island. At the federal level, the Equal Employment Opportunity Commission (EEOC) clarified in 2012 that a criminal offense must be directly related to the essential duties of the position in order for it to be used as a reason not to hire an individual. CLICK FOR FULL BRIEF

BenefitsBuzz: AUGUST!

AugustDID YOU KNOW? On June 20, the Department of Labor (DOL) issued a proposed rule that would expand Family and Medical Leave Act (FMLA) leave rights for same-sex spouses. The proposal would use the “place of celebration” rule, meaning that FMLA eligibility would be determined by legality of same-sex marriage in the state where the marriage was performed. This replaces the “state of residence” rule which determined eligibility based on the state where the employee resided. The rule would also redefine “spouse” under the FMLA to expressly reference the inclusion of same-sex marriages in addition to common law marriages, and include same-sex marriages entered into abroad. Supreme Court Changes Rules on Contraceptive Mandate Under the Affordable Care Act (ACA), non-grandfathered health plans are required to provide certain preventive care services for women, including contraceptives, without charging a copayment, deductible or coinsurance. Under the guidelines, plans must cover all FDA-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity. However, three closely held for-profit corporations (Hobby Lobby Stores, Mardel and Conestoga Wood Specialties) challenged the ACA’s requirement on the grounds that doing so would violate the right to exercise religious belief under the Religious Freedom Restoration Act (RFRA). On June 30, the Supreme Court issued a ruling agreeing with the plaintiffs, finding that the ACA’s contraceptive mandate, as applied to closely held corporations with sincere religious objections, violates the RFRA.   Full August Benefits Buzz

Compliance Bulletin: EEOC Issues New Enforcement Guidance on Pregnancy Discrimination

On July 14, 2014, the Equal Employment Opportunity Commission (EEOC) issued new enforcement guidelines on the treatment of pregnant employees under the Pregnancy Discrimination Act (PDA) and the Americans with Disabilities Act (ADA). The guidance is the EEOC’s first comprehensive update on the subject of pregnancy discrimination in over 30 years and is effective immediately. In addition to the guidance, the EEOC released a fact sheet for small businesses as well as a Question and Answer document explaining the laws and policy changes. In doing so, the EEOC has clarified its position on a number of key topics related to pregnancy discrimination. Extent of PDA Coverage The EEOC’s guidance clarifies which individuals are covered by the PDA. According to the EEOC, the PDA prohibits discrimination based not only on an employee’s current pregnancy, but also on past pregnancies and an employee’s potential or intention to become pregnant in the future. Additionally, the EEOC reinforced that the PDA covers all aspects of employment, including firing, hiring, promotions, health benefits and treatment, in comparison with non-pregnant persons in their similar ability or inability to work. Medical Conditions Related to Pregnancy or Childbirth The EEOC points out that the PDA prohibits employers from discriminating against women with medical conditions related to pregnancy or childbirth, and requires employers  to treat them the same as other employees who are similar in their ability to work but are not affected by pregnancy, childbirth or related medical conditions. Significantly, the EEOC’s guidance states that lactation and breastfeeding are pregnancy-related medical conditions protected under the PDA. Accordingly, employers must ensure that employees have the same freedom to address lactation-related needs as other employees have to address other similarly limiting medical conditions. For example, if an employer allows employees to change their schedules or use sick leave for routine doctor appointments to address non-incapacitating medical conditions, then it must allow female employees to change their schedules or use sick leave for lactation-related needs. CLICK HERE TO READ MORE

Health Care Reform: Federal Courts Issue Conflicting Rulings on Subsidies

confused Several lawsuits have been filed by individuals and employers to challenge the ability of the federal government to provide tax credits under the Affordable Care Act (ACA) to individuals in states that did not establish their own Exchanges (that is, in states with federally-facilitated exchanges, or FFEs). These lawsuits were filed in response to an Internal Revenue Service (IRS) rule that authorizes subsidies in all states, including those with FFEs. On July 22, 2014, two federal appeals courts—the District of Columbia Circuit Court and the 4th U.S. Circuit Court—issued inconsistent rulings on the availability of subsidies in states with FFEs.
  • In Halbig v. Burwell, the D.C. Circuit Court held that the IRS rule authorizing subsidies in states with FFEs is invalid. In a 2-1 opinion, the court ruled that the text of the ACA clearly restricts the subsidies to individuals in states that established their own Exchanges.
  • In King v. Burwell, the 4th Circuit Court unanimously upheld the availability of the ACA’s subsidies in states with their own Exchanges and in states with FFEs.