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Welcome to the Benefits, Inc. Newsletter!
Thank you for being part of Benefits, Inc. The landscape of the business world is changing every day. This newsletter is provided in order to inform you of up to date and accurate information regarding federal and state legislation, HR trends, compliance, and benefit strategies.
We appreciate your business and if you have any questions please feel free to contact us at 615-446-3303.
Sincerely,
Tim White & Kevin Smith
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Compliance Corner with Norma
SHOP Delayed?
You may have heard that the SHOP Exchange has been delayed until 2015. You may also have heard that open enrollment for the SHOP Exchange begins on October 1, 2013.
The SHOP Exchange will begin its initial open enrollment on October 1, 2013. So what has been delayed?
To answer that question, we need to look at what the SHOP is supposed to do for small businesses. The SHOP Exchange is intended to give small employers with less than 50 employees more choices in selecting group health coverage for employees.
The key feature allows employers to offer different plan options from different insurance companies. This is a radical change from the current market in which an employer chooses one insurer and, maybe, a couple of different levels of deductibles and co-pays.
Of course, choices create complexity. How can a small employer ensure that each insurer is paid the correct premium for the coverage selected by each employee? That led to the second key feature of the SHOP Exchange known as "aggregating" the premium. The employer collects the premium owed to all the insurers chosen by employees and sends the total amount to the SHOP Exchange. The Exchange is responsible for doling out the amount of premium owed to each insurer.
These key features of the SHOP Exchange require employers and employees, insurers, and the Exchange to communicate electronically. After all, the Exchange is essentially a secure web portal for exchanging protected health information and selecting health coverage.
It is no surprise that the U.S. Department of Health and Human Services (HHS) concluded that all the new complex features of the SHOP Exchange could not be implemented before open enrollment begins on October 1, 2013. So HHS decided to delay the two key features of the SHOP Exchange until the 2015 plan year.
What does that mean?
For the 2014 plan year, the SHOP Exchange will look pretty much like the current market place, where employers select one insurer with coverage at different deductible and co-pay levels. Small employers should work with their insurance agent/broker to compare health coverage offered on and off the Exchange in order to select a plan that best fits the needs of its employees.
Disclaimer: The information above is general in nature and does not constitute legal or tax advice on the issues discussed. Please consult a lawyer or tax professional to discuss your company's specific circumstances.
Norma Shirk
Manager/Owner
Corporate Compliance Risk Advisor, LLC
norma.shirk@complianceriskadvisor.com |
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New Summary of Benefits and Coverage Template for 2014
Employers responsible for distributing a summary of benefits and coverage (SBC) to employees in connection with group health plan coverage will need to include additional language to satisfy new requirements under Health Care Reform becoming effective in 2014. An updated SBC template, which includes the new language, is now available for SBCs provided with respect to coverage beginning on or after January 1, 2014 and before January 1, 2015.
SBC Notice Requirements
Group health plans are required to provide, without charge, a standard SBC form explaining plan coverage and costs to employees at specified times during the enrollment process and upon request. For insured group health plans, the notice requirement may be satisfied if the issuer furnishes recipients with a timely and complete SBC.
New Language Required for 2014 | |
The updated SBC template includes additional language indicating whether the plan provides "minimum essential coverage" (the type of coverage an individual needs to satisfy the individual responsibility requirement), and whether the plan meets the "minimum value" standard under Health Care Reform (meaning the plan pays for at least 60% of covered health care expenses).
FAQs issued simultaneously provide some relief for plans already working on preparing SBCs for 2014, where adding the new information to the template would present an administrative burden. To the extent a plan is unable to modify the SBC template for coverage beginning on or after January 1, 2014 and before January 1, 2015, a plan may use the previously authorized template, so long as the SBC is furnished with a cover letter or similar disclosure stating whether the plan does or does not provide "minimum essential coverage" and "minimum value."
For More Information
The FAQs also extend, through the end of 2014, various enforcement relief for complying with the SBC requirements that is currently in effect, including the emphasis on assisting (rather than imposing penalties on) plans that are working diligently and in good faith to provide the required SBC content.
Visit our section on Health Care Reform to download additional model notices available for employers and group health plans.
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Source: HR360.com |
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Key Employer Choice Feature of SHOP Exchanges Delayed Until 2015
A recently issued proposed rule delays the option for employers to offer employees a choice of qualified health plans through the new Health Insurance Exchanges, until plan years beginning on or after January 1, 2015.
Small Business Health Options Program (SHOP)
Beginning in 2014, Exchanges are required to operate SHOPs as an option for qualified small employers to purchase employee health coverage. The federal government will operate the program in states that do not elect to establish an Exchange.
Under the law, SHOPs must allow employers to choose the level of coverage to offer (bronze, silver, gold, or platinum), define their contribution toward employees' coverage, and then offer employees choices of multiple insurers and plans. SHOPs may also allow employers to offer one or more qualified health plans to employees by other methods, such as allowing the employer to choose a single plan for employees.
Proposed Rule Postpones Choice Feature
In response to operational challenges, the proposed rule delays the requirement for all SHOPs to provide employers the option to offer employees a choice of any qualified health plan at a single metal level, until plan years beginning on or after January 1, 2015.
Under the proposed rule, for plan years beginning in calendar year 2014, federally-facilitated SHOPs will only provide employers the option to make available to qualified employees a single qualified health plan. State-based SHOPs would have the flexibility to permit employers to offer their qualified employees a choice of plans at a single level of coverage.
Our Summary by Year offers updates on other requirements related to Health Care Reform.
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Unpaid Internships: What Employers Need to Know About the Fair Labor Standards Act Summer is a popular time for hiring interns, but did you know that internships are most often considered 'employment' subject to the federal minimum wage and overtime rules? The Fair Labor Standards Act
Under the federal Fair Labor Standards Act (FLSA), non-exempt individuals who are 'suffered or permitted' to work must be compensated for the services they perform for an employer. Interns who qualify as employees typically must be paid at least the federal minimum wage of $7.25 per hour, as well as overtime compensation at a rate of not less than one and one-half times the regular rate of pay after 40 hours of work in a workweek. The Test for Unpaid Interns
There are some circumstances under which individuals who participate in for-profit private sector internships or training programs may do so without compensation. This may apply to interns who receive training for their own educational benefit if the training meets certain criteria. The determination of whether an internship or training program meets this exclusion depends upon all of the facts and circumstances of each program. The U.S. Department of Labor (DOL) uses the following six criteria which must be applied when making this determination: - The internship, even though it includes actual operation of the facilities of the employer, is similar to training which would be given in an educational environment;
- The internship experience is for the benefit of the intern;
- The intern does not displace regular employees, but works under close supervision of existing staff;
- The employer that provides the training derives no immediate advantage from the activities of the intern, and on occasion its operations may actually be impeded;
- The intern is not necessarily entitled to a job at the conclusion of the internship; and
- The employer and the intern understand that the intern is not entitled to wages for the time spent in the internship.
If all of the factors listed above are met, an employment relationship likely does not exist under federal law, and the FLSA's minimum wage and overtime provisions do not apply to the intern. This exclusion from the definition of employment is quite narrow because the FLSA's definition of 'employ' is very broad. For a more detailed explanation of the factors used in the test for unpaid interns, please review the DOL Internship Programs Fact Sheet. Our section on Employee Pay provides information on other common federal wage issues. Source: HR360.com |
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5 Tips for Keeping Stress at Work in Check
Stress in the workplace, whether triggered by significant workloads or pressing deadlines, can sidetrack employees and prevent them from doing their best. The following simple steps for managers and employees can help reduce the pressure and increase team performance and productivity:
- Avoid Setting Unrealistic Goals. Setting achievable goals with reasonable timelines helps your sense of accomplishment grow while your stress level declines.
- Step-Out Complicated Projects. Dividing a complex project into phases provides specific direction, helps maintain a calm environment, and motivates the team. Daily or weekly to-do lists can also help prioritize tasks.
- Make Time for Meetings and Completing Tasks. Blocking out the time necessary to complete a task on your calendar is just as important as scheduling time for meetings.
- Communicate Regularly. Recognizing employee achievements can increase confidence, as well as reduce stress related to workloads. Employees may also be able to help identify new ways that they can contribute.
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Schedule Time for Exercise. A regular exercise routine can help lower stress and recharge your batteries for the challenges ahead.
Remember that laughter can be one of the best stress relievers of all--when things start to get too intense, it could be time for a little humor to lighten the load. For more tips on improving employee performance, visit our section on Motivating Employees.
Source: HR360.com
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Reminder: Employers Must Use New Version of Form I-9 Beginning May 7, 2013
Employers needing additional time to switch to the new Form I-9 (released in March) have until May 7th to begin using the revised version. Federal law requires all U.S. employers to verify the identity and employment eligibility of employees hired to work in the United States by completing Form I-9.
Prior versions of the Form I-9 will no longer be accepted effective May 7th, 2013. Employers should not complete a new Form I-9 for current employees if a properly completed Form I-9 is already on file.
Visit our section on Form I-9 for guidelines and FAQs on how to comply with the Form I-9 requirements.
Source: HR360.com
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Did You Know?
How would you pay your bills if you became ill or injured and could not earn a paycheck?
Income replacement policies, or individual disability insurance, can help in situations such as these.
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About Benefits, Inc.
Benefits,Inc. is a full service employee benefits agency. However we also offer Business Insurance, Work Comp, and Risk Analysis. Contact us today at 615-446-3303 for more information. |
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