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Wellness Programs Feeling the Heat as the EEOC Increases Its Efforts - Part 1

Wellness Programs Feeling the Heat as the EEOC Increases Its Efforts - Part 1

While wellness programs have increased in popularity, according to the 2014 UBA Health Plan Survey, actual wellness program adoption has been in a holding pattern. As one might expect, the highest percentage (58.8%) of plans offering wellness benefits came from employers with 1,000 or more employees and the lowest percentage (8%) of plans offering wellness benefits came from employers with fewer than 25 employees. On average, wellness programs are down slightly by 1.3%. It’s no wonder given all the pending litigation and regulation surrounding these programs, including the fact that the health of an employee population is no longer a rating factor for smaller employers.

2015 Cost-of-Living Adjustments

2015 Cost-of-Living Adjustments

Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an "indexed" limit). The Internal Revenue Service and the Social Security Administration have released a number of indexed figures for 2015.

2014 UBA Health Plan Survey Shows Rate Reprieve for Small Employers

2014 UBA Health Plan Survey Shows Rate Reprieve for Small Employers Graph 1 resized 600

Data in the 2014 UBA Health Plan Survey is based on responses from 9,950 employers sponsoring 16,967 health plans nationwide. Results are applicable to the small to midsize market that makes up a majority of American businesses, as well as to larger employers, providing benchmarking data on a more detailed level than any other survey. To help employers benchmark their health plan costs by organization size, the chart below shows average costs in descending order.

Supreme Court Agrees to Rule on Availability of Premium Tax Credits

Supreme Court Agrees to Rule on Availability of Premium Tax Credits

Premium tax credits are only available to individuals who obtain health coverage through a Marketplace. A dispute has arisen as to whether the IRS has the ability to interpret PPACA to allow the subsidy to individuals who obtain coverage through any Marketplace, or whether the language of PPACA limits eligibility to those who have obtained coverage through a state Marketplace. The U.S. Supreme Court has agreed to rule on whether premium tax credits may only be available to individuals who receive tax subsidies as a result of being enrolled in a state exchange. In the meantime, the IRS has stated that it will continue to issue tax credits to individuals in both state and federally-run Marketplaces.

The “Play or Pay” Package

The Play or Pay Package

The employer-shared responsibility (“play or pay”) requirements do not apply to small employers and have been delayed until 2016 for most mid-sized employers. This raises the question – what exactly is included in the play or pay requirement, which a small employer may be able to ignore and that mid-size employer may not need to meet until later?

UBA 2014 Health Plan Survey Executive Summary Now Available

UBA Health Plan Benchmarking Survey

Since 2005, United Benefit Advisors® (UBA) has surveyed thousands of employers across the nation regarding their health plan offerings, their ongoing plan decisions in the face of significant legislative and marketplace changes, and the impact of these changes on their employees and businesses. The UBA survey represents the nation’s largest health plan benchmarking survey and the most comprehensive source of reliable benchmarking data.

Group Health Plans That Do Not Cover Inpatient Hospital or Physician Services

Group Health Plans That Do Not Cover Inpatient Hospital or Physician Services

Beginning in 2015, large employers must offer affordable, minimum value coverage to their full-time employees or potentially pay a penalty. Some companies have been marketing a plan that they state satisfies the minimum value requirement (an actuarial value of 60%), based upon a calculator provided by the Department of Health and Human Services (HHS), even though the plan does not cover inpatient hospital charges. In Notice 2014-69, HHS and the IRS state that plans that do not provide substantial coverage for physician and inpatient hospital services will not be considered minimum value plans, and that the result obtained through the HHS calculator should not be considered valid since that calculator was built on the assumption that a traditional plan design would be used. The agencies do recognize that some employers have already implemented these plans based on the calculator results, and the Notice states that a limited exception will be available to those employers. To be able to use the exception:

Transitional Reinsurance Fee Filing Date Extended to December 5

TRF Filing Date Extended to December 5

The Centers for Medicare and Medicaid Services (CMS) extended the deadline for group health plans to provide their 2014 transitional reinsurance fee (TRF) submission. Filing is now due by 11:59 p.m. on December 5, 2014. The January 15, 2015, and November 15, 2015, deadlines to pay the fee remain the same. For more information on the TRF, see our recent blog. For the answers to nearly 30 questions about filing, due dates, calculation methods, payment, submission and more, CLICK HERE to Request UBA's "Frequently Asked Questions about the Transitional Reinsurance Fee (TRF)".

Independent Contractor vs Employee

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By K. Michael Ward, MPH, SPHR, GPHR, Employee Benefits Advisor
The Wilson Agency
A UBA Partner Firm

As a business professional who is trying to classify a worker, it is important to remain compliant with the IRS regulations that determine whether an individual providing services to your organization should be classified as an independent contractor or an employee.



Can Employers Assist Employees with Premiums for Individual Plans?

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On November 6, 2014, the collective Departments of Health and Human Services (HHS), Labor (DOL) and the Treasury released three Frequently Asked Questions (FAQs) directed at employer payment plans for the purchase of individual insurance. While the departments had previously released several other pieces of guidance about these arrangements, this latest round exclaimed an emphatic no!

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