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CMS Disclosure Requirement for Employer Health Plans | Maryland Benefit Consultants

Do you offer health coverage to your employees? Does your group health plan cover outpatient prescription drugs? If so, federal law requires you to complete an online disclosure form every year with information about your plan’s drug coverage. You have 60 days from the start of your health plan year to complete the form. For instance, for a calendar-year health plan, this year’s deadline is March 1, 2018.

Background

The Centers for Medicare and Medicaid Services (CMS) is a federal agency that collects data and administers various federal programs. The agency utilizes the CMS online tool to collect information from employers about whether their group health plan’s prescription drug coverage is creditable or noncreditable. Creditable coverage means the group health plan’s prescription drug coverage is actuarially equivalent to Medicare’s Part D drug plans. In other words, the group plan is considered creditable if its drug benefits are as good as or better than Medicare’s benefits.

To confirm whether your plan provides creditable or noncreditable coverage, check with the plan’s carrier or HMO (if insured) or the plan’s actuary (if self-funded). CMS provides guidance to help plan sponsors, carriers, and actuaries determine the plan’s status.

Deadline for Disclosure

All group health plans that include any outpatient prescription drug benefits, regardless of whether the plan is insured, self-funded, grandfathered, or nongrandfathered, must complete the CMS disclosure requirement. There is no exception for small employers.

Complete the CMS online disclosure form every year within 60 days of the start of the plan year. For instance, for calendar-year plans, this year’s deadline is March 1, 2018.

Additionally, if your plan terminates or its status changes between creditable and noncreditable coverage, you must disclose the updated information to CMS within 30 days of the change.

Completing the Disclosure Form

The CMS online tool is the only method allowed for completing the required disclosure. From this link, follow the prompts to respond to a series of questions regarding the plan. The link is the same regardless of whether the employer’s plan provides creditable or noncreditable coverage.

The entire process usually takes only 5 or 10 minutes to complete. To save time, have the following information handy before you start filling in the form:

  • Information about the plan sponsor (employer): Name, address, phone number, and federal Employer Identification Number (EIN).
  • Number of prescription drug options offered (e.g., if employer offers two plan options with different benefit levels, the number is “2”).
  • Creditable/Noncreditable Offer: Indicate whether all options are creditable or noncreditable or whether some are creditable and others are noncreditable.
  • Plan year beginning and ending dates.
  • Estimated number of plan participants eligible for Medicare (and how many are participants in the employer’s retiree health plan, if any).
  • Date that the plan’s Notice of Creditable (or Noncreditable) Coverage was provided to participants.
  • Name, title, and email address of the employer’s authorized individual completing the disclosure.

We suggest you print a copy of the completed disclosure to keep for your records.

Note: Employers that receive the Retiree Drug Subsidy (RDS), or sponsor health plans that contract directly with one or more Medicare Part D plans, should seek the advice of legal counsel regarding the applicable disclosure requirements.

Additional Disclosure Requirement

Separate from the CMS online disclosure requirement, employers also must distribute a disclosure notice to Medicare-eligible group health plan participants. The deadline for distributing the participant notice is October 14 of the preceding year. It often is difficult for employers to identify which employees and spouses may be Medicare-eligible, so most employers simply distribute the notice to all participants regardless of age or status. For information about the notice requirement, see our previous post.

Originally published by www.ThinkHR.com

Benefits Easy: Intro to Self-Funding | Maryland Benefit Advisors

As the first month of 2018 wraps up, companies have already begun the arduous task of submitting budgets and finding ways to cut costs for the new year. One of the most effective ways to combat increasing health care costs for companies is to move to a Self-Funded insurance plan. By paying for claims out-of-pocket instead of paying a premium to an insurance carrier, companies can save around 20% in administration costs and state taxes. That’s quite a cost savings!

The topic of Self-Funding is huge and so we want to break it down into smaller bites for you to digest. This month we want to tackle a basic introduction to Self-Funding and in the coming months, we will cover the benefits, risks, and the stop-loss associated with this type of plan.

THE BASICS

  • When the employer assumes the financial risk for providing health care benefits to its employees, this is called Self-Funding.
  • Self-Funded plans allow the employer to tailor the benefits plan design to best suit their employees. Employers can look at the demographics of their workforce and decide which benefits would be most utilized as well as cut benefits that are forecasted to be underutilized.
  • While previously most used by large companies, small and mid-sized companies, even with as few as 25 employees, are seeing cost benefits to moving to Self-Funded insurance plans.
  • Companies pay no state premium taxes on self-funded expenditures. This savings is around 5% – 3/5% depending on in which state the company operates.
  • Since employers are paying for claims, they have access to claims data. While keeping within HIPAA privacy guidelines, the employer can identify and reach out to employees with certain at-risk conditions (diabetes, heart disease, stroke) and offer assistance with combating these health concerns. This also allows greater population-wide health intervention like weight loss programs and smoking cessation assistance.
  • Companies typically hire third-party administrators (TPA) to help design and administer the insurance plans. This allows greater control of the plan benefits and claims payments for the company.

As you can see, Self-Funding has many facets. It’s important to gather as much information as you can and weigh the benefits and risks of moving from a Fully-Funded plan for your company to a Self-Funded one. Doing your research and making the move to a Self-Funded plan could help you gain greater control on your healthcare costs and allow you to design an original plan that best fits your employees.

2018 W-4 Forms Won’t Be Released Until Late February | MD Benefit Advisors

If you’ve been getting questions from your employees about completing new 2018 W-4 forms to take advantage of the tax reform rules, we’ve finally received some answers. You can continue to rely on the current W-4 forms for now until the new 2018 form is released in late February.

The January 29th Internal Revenue Service (IRS) Notice 2018-14 provides additional guidance on the income withholding rules that were changed under the recently passed Tax Cuts and Jobs Act. The guidance:

  • Extends the effective period of Forms W-4 furnished to claim exemption from withholding for 2017 until February 28, 2018.
  • Permits employees to claim exemption from withholding for 2018 by temporarily using the 2017 Form W-4. This procedure will expire 30 days after the 2018 Form W-4 is released.
  • States that employees experiencing a change in status that causes a reduction in the number of withholding exemptions are not required to furnish employers with new withholding certificates until 30 days after the 2018 Form W-4 is released.
  • Provides that employees who have a reduction in the number of withholding allowances solely due to changes made by the Tax Cuts and Jobs Act are not required to furnish employers with new withholding certificates during 2018. However, employees may choose to update their withholding at any time in response to the act. Employees who choose to update their withholding may use the 2017 Form W-4 instead of the 2018 Form W-4 to report changes in withholding allowances until 30 days after the 2018 Form W-4 is released.
  • Confirms that the optional withholding rate on supplemental wage payments is 22 percent for 2018 through 2025.
  • Specifies that, for 2018, withholding under IRC 3405(a)(4) on periodic payments when no withholding certificate is in effect will be based on treating the payee as a married individual claiming three withholding allowances.

In addition to the guidance, the IRS also released a new Publication 15, (Circular E), Employer Tax Guide, for 2018. Publication 15 includes the 2018 withholding tables and explains an employer’s tax responsibilities, such as withholding, depositing, reporting, paying, and correcting employment taxes.

ThinkHR will continue to follow developments in this area and report on the availability of the new 2018 W-4 Form and other IRS guidance as it becomes available.

By Rick Montgomery

Originally published by www.ThinkHR.com

Maryland Employment Law Update – January 2018 | Maryland Benefit Consultants

Unemployment Poster Updated

The Maryland Department of Labor, Licensing and Regulation, Office of Unemployment Insurance updated its Unemployment Insurance Law poster (revised 9-17). The notice must be posted in a conspicuous area in the workplace.

Download the poster

Nothing Is Certain, But Death and LESS Taxes… | MD Benefit Consultants

On January 11, 2018, the Internal Revenue Service released its income tax withholding tables for 2018 reflecting changes made by the December 2017 tax reform legislation. The updated withholding information provides the new rates for employers to use during 2018. Employers are encouraged to use these tables as soon as possible but must use them by no later than February 15, 2018. Employers should continue to use the 2017 withholding tables until they implement the 2018 withholding tables.

According to the U.S. Treasury, an estimated 90 percent of paycheck recipients are likely to see an increase in their take-home pay by February. However, when employees see these changes in their paychecks depends on how quickly the new tables are implemented by their employers and how often they are paid (usually weekly, biweekly, or semimonthly).

To help individuals identify the correct amount of withholding, the IRS is releasing a revised withholding calculator by the end of February, which will be posted on IRS.gov. The IRS encourages taxpayers to use the calculator to adjust their withholding once it is released.

Changes for 2018 and Looking Forward

The new law makes many changes for 2018 that affect individual taxpayers, including an increase in the standard deduction, repeal of personal exemptions, and changes in tax rates and brackets. In relation to Form W-4, these new withholding tables are designed to work with employees’ current W-4, as filed with their employer; so, there are no steps employees must currently take regarding the new tables and law.

The IRS is also working on revising the Form W-4 to reflect the newly available itemized deductions, increases in the child tax credit, the new dependent credit, and repeal of dependent exemptions. However, there is no set release date for the revised form.

Once released, employees may use the new Form W-4 to update their withholding in response to the new law or changes in their personal circumstances in 2018, and by workers starting a new job. Until a new Form W-4 is issued, employees and employers should continue to use the 2017 Form W-4.

For Now

At this time, employers should be reviewing these new tables and implementing necessary changes. For 2019, the IRS has said that it anticipates making even more changes involving withholding. But don’t despair; the agency provides FAQs, which employers and employee may find useful, and pledges to work with the business and payroll community to encourage workers to file new Forms W-4 next year while sharing information on changes in the new tax law that impact withholding.

Stay tuned though, because 2018 has only just begun.

By Samantha Yurman

Originally published by www.ThinkHR.com

So Who Is a Paid Intern Now? | MD Benefit Advisors

On January 5, 2018, the U.S. Department of Labor’s Wage and Hour Division (WHD) created new guidance for determining whether a worker could be classified as an unpaid intern under the federal Fair Labor Standards Act (FLSA). The FLSA requires “for-profit” employers to pay employees for their work. Interns, however, may not be classified as “employees” under the FLSA and therefore are not entitled to compensation for their work. The new rules give employers more flexibility in establishing unpaid internships.

Under the previous six-factor test, an intern was considered an employee entitled to compensation unless all of the following factors were met:

  1. The internship, even though it included actual operation of the facilities of the employer, was similar to training that would be given in an educational environment;
  2. The internship experience was for the benefit of the intern;
  3. The intern did not displace regular employees, but worked under close supervision of existing staff;
  4. The employer that provided the training derived no immediate advantage from the activities of the intern, and on occasion its operations may actually have been impeded;
  5. The intern was not necessarily entitled to a job at the conclusion of the internship; and
  6. The employer and the intern understood that the intern was not entitled to wages for the time spent in the internship.

In its new guidance (Field Assistance Bulletin No. 2018-2), the WHD has adopted the “primary beneficiary test,” favored by several federal Circuit Courts, as the standard for determining whether interns at for-profit employers are employees under the FLSA. The primary beneficiary test examines the economic reality of the intern-employer relationship to determine which party is the primary beneficiary of the relationship. The following seven factors are used to make this determination:

  1. The extent to which the intern and the employer clearly understand that there is no expectation of compensation. Any promise of compensation, express or implied, suggests that the intern is an employee — and vice versa.
  2. The extent to which the internship provides training that would be similar to that which would be given in an educational environment, including the clinical and other hands-on training provided by educational institutions.
  3. The extent to which the internship is tied to the intern’s formal education program by integrated coursework or the receipt of academic credit.
  4. The extent to which the internship accommodates the intern’s academic commitments by corresponding to the academic calendar.
  5. The extent to which the internship’s duration is limited to the period in which the internship provides the intern with beneficial learning.
  6. The extent to which the intern’s work complements, rather than displaces, the work of paid employees while providing significant educational benefits to the intern.
  7. The extent to which the intern and the employer understand that the internship is conducted without entitlement to a paid job after the internship.

What is different now is that not ALL of the seven factors must be met in order to determine employee status. According to the WHD, no single factor is decisive and the determination must be made on the unique circumstances of each case.

If analysis of these facts reveals that an intern is actually an employee, then he or she is entitled to both minimum wage and overtime pay under the FLSA. Conversely, if the analysis confirms that the intern or student is not an employee, then he or she is not entitled to either minimum wage or overtime pay under the FLSA.

What This Means for Employers

As a result of the new guidance, employers should review the status of any person working for them that they consider an “intern” and update their current internship programs to consider the WHD’s new rules.

Originally posted by www.ThinkHR.com

New Year, New Penalties | Maryland Benefit Advisors

Department of Labor Publishes Updated Penalties for OSHA Violations

On January 2, 2018, the U.S. Department of Labor (DOL) published updated, inflation-adjusted penalties for violations of various laws regulated by the DOL and its internal components or divisions, including the Occupational Health and Safety Administration (OSHA). The DOL is required to adjust the level of civil monetary penalties for inflation by January 15 each year pursuant to the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 (Inflation Adjustment Act).

Because of the Inflation Adjustment Act, rates for OSHA penalties have increased three times in the last 17 months (August 1, 2016, January 13, 2017, and January 2, 2018). Therefore, for violations occurring after November 2, 2015, the penalty amounts incurred by employers will depend on when the penalty is assessed, as follows:

  • If the penalty was assessed after August 1, 2016 but on or before January 13, 2017, then the August 1, 2016 penalty level applies.
  • If the penalty was assessed after January 13, 2017 but on or before January 2, 2018, then the January 13, 2017 penalty level applies.
  • If the penalty was assessed after January 2, 2018, then the current penalty level applies.

The applicable January 2, 2018 penalty levels for violations of the Occupational Safety and Health Act of 1970 (OSH Act) are as follows:

  • Willful violations: $9,239 – 129,936 (up from $9,054 – $126,749 after January 13, 2017 and $8,908 – $124,709 after August 1, 2016)
  • Repeated violations: $129,936 (up from $126,749 after January 13, 2017 and $124,709 after August 1, 2016)
  • Serious violations: $12,934 (up from $12,675 after January 13, 2017 and $12,471 after August 1, 2016)
  • Other-than-serious violations: $12,934 (up from $12,675 after January 13, 2017 and $12,471 after August 1, 2016)
  • Failure to correct violations: $12,934 (up from $12,675 after January 13, 2017 and $12,471 after August 1, 2016)
  • Posting requirement violations: $12,934 (up from $12,675 after January 13, 2017 and $12,471 after August 1, 2016)

These increases apply to states with federal OSHA programs and states with OSHA-approved state plans. Violations occurring on or before November 2, 2015 are assessed at pre-August 1, 2016 levels.

Employers are encouraged to familiarize themselves with these increased penalties and consult counsel if they have questions about the penalty level applicable to a potential violation.

By Nicole Quinn-Gato

Originally posted by www.ThinkHR.com

Driving in to 2018 | Maryland Benefit Advisors

How Changes to the Mileage Reimbursement Rate and Qualified Transportation Benefits Will Impact Employers in 2018

On December 14, 2017, the Internal Revenue Service released the 2018 standard mileage rates used to calculate deductible costs of operating vehicles for business purposes. The rate increased by one cent  from 53.5 cents in 2017 to 54.5 cents in 2018. Employers who adopt the IRS standard mileage reimbursement rate in their employee handbook or other employment policy will need to update their reimbursement practices to reflect this change.

Additionally, as we previously reported, the tax plan signed into law by President Trump on December 22, 2017 impacts qualified transportation benefits (also known as commuter benefits). In the past, employers could deduct the amount they provide toward an employee’s qualified parking, transit passes, or vanpool expenses up to certain federal limits ($255 in 2017 and $260 in 2018) as a business expense. However, under the new tax law, employers can no longer deduct this expense beginning in 2018. Moreover, while employees can continue to exclude qualified parking and transit benefits from their income, qualified bicycle commuting expenses will no longer be excludable.

The tax law requires the Secretary of Treasury to issue regulations or other guidance as necessary to implement these changes; however, the law goes into effect for all amounts paid or incurred after December 31, 2017. Employers who have already budgeted for 2018 may need to review their assumptions to measure the impact of these taxable expenses.

Employers should consult tax or legal professionals to determine the best options for handling parking and other commuter policies should they want to change existing policies.

By Nicole Quinn-Gato

Originally published by www.ThinkHR.com

IRS Extends Deadline for Employers to Furnish Forms 1095-C and 1095-B | Maryland Benefit Advisors

On December 22, 2017, the IRS released Notice 2018-06 to extend the due date for employers to furnish 2017 Form 1095-C or 1095-B under the Affordable Care Act’s employer reporting requirement. Employers will have an extra 30 days to prepare and distribute the 2017 form to individuals. The due dates for filing forms with the IRS are not extended.

Background

Applicable large employers (ALEs), who generally are entities that employed 50 or more full-time and full-time-equivalent employees in 2016, are required to report information about the health coverage they offered or did not offer to certain employees in 2017. To meet this reporting requirement, the ALE will furnish Form 1095-C to the employee or former employee and file copies, along with transmittal Form 1094-C, with the IRS.

Employers, regardless of size, that sponsored a self-funded (self-insured) health plan providing minimum essential coverage in 2017 are required to report coverage information about enrollees. To meet this reporting requirement, the employer will furnish Form 1095-B to the primary enrollee and file copies, along with transmittal Form 1094-B, with the IRS. Self-funded employers who also are ALEs may use Forms 1095-C and 1094-C in lieu of Forms 1095-B and 1094-B.

Extended Due Dates

Specifically, Notice 2018-06 extends the following due dates:

  • The deadline for furnishing 2017 Form 1095-C, or Form 1095-B, if applicable, to employees and individuals is March 2, 2018 (extended from January 31, 2018).
  • The deadline for filing copies of the 2017 Forms 1095-C, along with transmittal Form 1094-C (or copies of Forms 1095-B with transmittal Form 1094-B), if applicable, remains unchanged:
    • If filing by paper, February 28, 2018.
    • If filing electronically, April 2, 2018.

The extended due date applies automatically so employers do not need to make individual requests for the extension.

More Information

Notice 2018-06 also extends transitional good-faith relief from certain penalties to the 2017 employer reporting requirements.

Lastly, the IRS encourages employers, insurers, and other reporting entities to furnish forms to individuals and file reports with the IRS as soon as they are ready.

Originally published by www.ThinkHR.com

Utilize FSA Monies with Key Year–End Strategies | Maryland Benefit Advisors

‘Tis the Season’. Like most, you ‘re probably in the midst of the “hussle and bussle” of this holiday season with dinners, parties, and activities; Christmas shopping; and spending those remaining FSA dollars you have allocated this year.

Wait, what? Yes, you read right. Chances are, if you’ve opted to utilize an employer-sponsored FSA account in 2017, you may have remaining funds you’ll need to spend. This is especially true if your employer opted for the $500 carryover rule in lieu of a grace period. Regardless of what flexible spending account you have, here are some strategies to get the most out of this benefit before year end.

Medical Care

Medical FSAs are the most common supplemental flexible coverage offered under employer benefit plans. If you’ve elected this coverage for 2017, here are a few things to consider when spending these funds.

Routine and Elective Medical Procedures

Whether routine or not, now’s the time to get appointments booked. If your employer offers a grace period for turning in receipts, you can book appointments into the first couple of months of the New Year and get reimbursed from this year’s funds without affecting 2018’s contributions. This has a two-fold advantage, as you can also spread next year’s deductible over the coming year.

Several routine and elective procedures that are FSA-eligible include:

  • Lasik
  • Sleep Apnea/Snoring
  • Hernia surgery
  • Colonoscopy
  • Smoking/Weight Loss Cessation Programs

Alternative Therapies

Under IRS law, certain alternative therapies are eligible for reimbursement. Acupuncture and chiropractic care, alternative medicinal treatments, and herbal supplements and remedies are a great way to use up your funds for the year and get a little cash back when you most need it.

Dental

Dental benefits often work differently than medical coverage. According to the American Dental Association, this benefit is often capped annually – generally between $1,000 and $3,000.  If you have unused funds remaining in your FSA, now may be the time to schedule a last-minute appointment with your dentist, especially if you might need serious work down the road. This way, you can use up the funds remaining in your account by year-end, and reduce your out-of-pocket expense next year by sharing the cost of additional dental services over a longer period of time.

Prescription Refills

Refilling your prescription medications at year end are a great way to use up your funds in your medical FSA. Take inventory of your prescription drugs, toss out expired ones, and make that call for a refill to your doctor or pharmacy.

Over the Counter Drugs, Medical Equipment and Supplies

Many OTC medications, medical equipment and supplies are eligible for reimbursement under a medical FSA. First-aid kits, blood-pressure monitors, thermometers, and joint braces are just a few.  Please note that some will require a note or prescription from your doctor.

Mileage and Other Healthcare-Related Extras

Traveling to and from any medical facility for appointments or treatment are eligible for reimbursement under your FSA. This not only includes traveling by your own vehicle, but also by bus, train, plane, ambulance service; and does include parking fees and tolls.

In addition, you can get reimbursed for other health-related expenses. These include:

  • Lodging and meals during a medical event.
  • Medical conferences concerning an illness of you or one of your dependents.
  • Advance Payments on a retirement home or long-term care.

Dependent Care

If you have opted to contribute to a DCFSA, you can get reimbursed for day care, preschool, summer camps and non-employer sponsored before and after school programs. In addition, funds contributed to this type of FSA can be used for elderly daycare if you’re covering more than 50% your parent’s maintenance costs.

Adoption Assistance

If you are contributing to an Adoption Assistance FSA offered by your employer, you can get reimbursed for any expenses incurred in the process of legally adopting an eligible child. Eligible expenses include adoption fees, attorney fees and court costs, medical expenses for a child prior to being placed for adoption, and related travel costs in association with the adoption process.

Make the most out of your FSA contributions by using the above strategies to your advantage as we close out 2017. As you move into 2018, review the maximum contribution guidelines for the coming year as set by the IRS, and establish a game plan on expenditures next year. Seek your HR department’s expertise for guidelines and tips they can give you to maximize this valuable benefit package.