2015 Benefit University: Employee Benefit Legal Update

30

Transcript of 2015 Benefit University: Employee Benefit Legal Update

2

Watch for upcoming resources

Cyber Liability: How to protect your employees

and minimize the threat to your company

March 3

Corporate Insurance Overview: What Every Forward-Thinking CFO & HR VP Need to Know

March 31 Webinar

Save The Date May 27th 2015

La Costa Resort & Spa

Ultimate Rewards A Results-Driven Approach to Total Rewards:

• Executive and broad-based compensation

• Sales compensation and incentive plan designs

• Compensation and performance management outsourcing

• Ultimate Rewards quick view and assessment

• Temporary assignments and permanent placement

7

Thank You To Our Sponsors!

Sibyl Bogardus provides compliance and consulting advice regarding employee benefits. Areas of expertise include federal healthcare reform, HIPAA, ADA, wellness, labor laws, COBRA, ERISA, FMLA, and compliance with tax requirements. Sibyl has been named as one of the 100 Leading Women in insurance by Business Insurance and one of the 25 Most Influential Business Women by the St. Louis Business Journal. She is a nationally recognized speaker on healthcare reform, medical plan design trends, state and federal laws, and human resources issues. A widely-published author on healthcare reform, employee benefits, tax, and labor law issues, Sibyl publishes articles each month in Health Reform Magazine. She is on the Editorial Advisory Board of Benefits Quarterly, a publication of the International Society of Certified Employee Benefit Specialists. She has given interviews for radio, magazines, and newspapers.

Sibyl

Bogardus

Chief Compliance Advisor, Attorney

Click to edit Master title style Employee Benefits Legal Update: Your Guide to Avoiding Legal Landmines

and Pitfalls in 2015

HUB International

Sibyl Bogardus

Chief Compliance Officer

© All Rights Reserved 2015

10

Agenda

• Tough - and valuable - lessons from 1/1/15 enrollments

and rollout of group health reform

• Will technology catch up to legal requirements?

• Effects of individual exchange enrollment, subsidies, and

premium payments

• The Supreme Court case - key dates and likely outcomes

• A Republican Congress - what we expect in 2015 & later

• Increased DOL & IRS audit activity – impact on you

• Dealing with 2015's top five expected developments

11

So, How Did THAT Feel?

Tough & valuable lessons from 1/1/15

enrollments & rollout of group health reform

• Communications

o Benefit guide re-alignment

o Enrollment meetings (“It lasted how long?”)

o Typical employee questions and concerns

• Enrollment percentages & changes

o Traditional core health plans

o Minimum value skinny

12

So, How Did THAT Feel? (cont.)

Tough & valuable lessons from 1/1/15

enrollments & rollout of group health reform

• Nontraditional plans

o ELAP (Medicare plus a percentage)

o Supplements

o Skeletons?

o No hospitalization…RIP

• Renewals / rate changes

o Large group

o Small group

o Fixed costs for self-funded plans

13

Key C-Suite Goal:

No Surprises on Additional Costs

• Opportunities to minimize financial and administrative

impacts

o The challenge: Migraine inducing, right?

o One answer: Technology, but who is ready?

• Standards for compliance in 2015/2016

o Budget for the offer

70% moving to 95%

Individual penalty impact

o Good faith on reporting

• Making a business case

o Who will be your internal partner? External?

14

Advance Planning Remains Crucial

Why and how to create a 3-5 year strategic

plan for healthcare reform

• The grid to guide you

• Work in flexibility

o Ongoing changes with agency interpretations

o Cadillac tax

o Need for fallback strategies

• Financial analysis for self-funding

• Monitor new benchmarks and approaches

15

Are Your Systems Ready?

• Tracking

o Hours worked, PTO, FMLA, Military Leave, jury duty

o Changes in position or job status

• Gathering date & reporting to employees & IRS

o Draft forms

o Impact as enforcement tool

• Premium adjustments and other nuances

Will technology catch up to legal requirements?

16

Staying on Top of Practical Issues

• Variable hour and seasonal classifications o Practical implications of premium collection

o Changing status of an employee:

Change to full-time (new hire … or other?)

Change to part-time (variable hour or full-time?)

“Wasn’t there another rule on…?”

o Leaves of absence

o PTO accruals

o Rate of pay changes

o Changing measurement periods

Remember – 70%! And remember to…Breathe!

17

Your employees are asking…

”What is happening?”!

Effects of individual exchange enrollment,

subsidies, and premium payments

• Inappropriate subsidies

• “Unique perspective” of state exchanges

• Pitfalls for the unwitting

o Uncoordinated & inadequate information

o Claw backs

• Beware unions & staffing/temp/ PEO firms

• “Help me with $, information/advice, tax forms”

18

Keep Employee Engagement

Facilitate human capital management

in the midst of these changes

• Cultural considerations

• Matching processes internally

• Avoid the Siren Song of public exchanges

• Education -- re-focus and emergence of "new" tools

19

What will the Court Say?

• The Supreme Court case

o Subsidies for citizens in state exchange (not federal?)

o Current # of state exchanges

• Key dates

o Arguments in March

o Decision before July 4th

• Possible outcomes

o Subsidies in any exchange

o Subsidies only in state exchanges

• Then what?

• Likely outcome…wait for it…wait for it….

20

Impact of Politics?

• Republican Congress

o 2/3

• Upcoming Presidential election

• What we expect in 2015 & later

o Hours adjustment to 40?

o Penalty elimination

o Mandate elimination

o Repeal? Or repeal & replace?

o The big fix in July, August, later

21

Implementation & Changing

of the Guard in 2016

• Expect a push & prepare for disruptive changes

• Want to get involved?

o Deal with facts: Regulatory agenda

o Federal requests for input

• Comment if an issue is important to you

o Example: k-12 substitute teachers

• Dual path -- compliance + advocacy

22

An Audit – How will that feel?

• Increased DOL & IRS audit activity

o Foreshadowing!

• Triggers

o Complaints

o Reporting

o Timing

• Immediate impact on you

• Fallout

o Cross-referrals

o Vendor impact

o The follow-through

23

Staying Out of Trouble

How to avoid the scams and shams

the IRS will be targeting in audits

• Individual policy payments or reimbursements

• Unearthing skeletons in your benefits closet

• Defined contribution software

• Payroll tax avoidance schemes

• More war stories

And don’t forget the DOL

• Employee communication

o Fiduciary responsibilities

• Building your Fiduciary File

24

Staying Ahead of the Curve

• What works, what doesn’t, and how to avoid

the wrong path

• Consider pros & cons

• Strong Trend: Collaboration

• Using influence – the “solution solution”

• Sample considerations for Cadillac Tax

o Supplemental benefits

o Eliminating the health plan

o Skinny plan options – not for everyone

o Self-funding

o Budgeting

25

Sweat (& Document) the Small Stuff

Example: Affordability safe harbors

• Three possible safe harbors

o W-2, Rate of Pay, Federal Poverty

• Practical application

• What about non-safe harbors?

Memorialize the path you have taken

Similar issues: waiting period, non-health eligibility,

measurement and coverage rules, transition relief for

effective date or delay, class outs, etc.

26

Sweat (& Document) the Small Stuff

Example: Employee Categories

• Variable hour, seasonal, and full-time

• Elimination of other categories for health benefits

• How to establish status

o With employees

o In HR documentation

• Addressing other benefits

Memorialize the path you have taken

27

Top 5 Expected Developments in 2015

1. Discrimination rules for insured plans

2. Final Forms 1095-C and related forms and instructions

for employee & IRS

3. Small employer guidance

• Effective dates

• Other… like required notices?

4. Automatic enrollment (200+ employees plus)

5. Cadillac Tax

• Perhaps as request for input

Q & A

Tell Us What

You Think

Click to edit Master title style Thank You!