Wage Parity Compliance

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NY Wage Parity and Your Home Health Care Business Yonina F. Shineweather, CPA [email protected] Zishe Glauber [email protected] 5/22/2014

description

NY Wage Parity Compliance and Your Home Health Care Business. Crucial information for Home Care and Home Health Aid (HHA) Companies who want to be in compliance with the NY Wage Parity law.

Transcript of Wage Parity Compliance

Page 1: Wage Parity Compliance

NY Wage Parity and Your Home Health Care Business

Yonina F. Shineweather, CPA [email protected]

!Zishe Glauber

[email protected]

5/22/2014

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Part I:

Wage Parity Compliance

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Public Health Law of § 3614-c Home Care Worker Wage Parity.

!!!Beginning March 1, 2012, established a minimum wage for home care aides who perform Medicaid reimbursed work for certified home health agencies (CHHAs), long term home health care programs (LTHHCPs) and managed care organizations (MCOs) within New York City and within the counties of Nassau, Suffolk and Westchester.

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Licensed home care services agencies (LHCSAs), including limited licensed home care agencies (LLHCSAs) !to the extent that they contract with a CHHA, LTHHCP or MCO !to provide services to clients of those entities in the specified locations !NOT LHCSAs who do not provide services thru the 3 above NOT Assisted Living Programs (ALPs) NOT Consumer Directed Personal Assistance Programs (CDPAP)

Who Else is Covered?

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A home care aide has primary responsibility for providing in-home assistance with: !

1. activities of daily living (ADL) 2. instrumental activities of daily living (IADL) or 3. health-related tasks.

!including !

1. home health aides 2. personal care aides 3. home attendants 4. home hospice care 5. any other licensed or unlicensed person whose primary

responsibility is to provide in home assistance with activities of daily living or health related tasks.

Which Employees are Covered?

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Which Employees are NOT Covered? !!

Anyone working on a “casual basis” = !!

๏ incidental ๏ irregular ๏ intermittent

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What about Dually Eligible Cases? !Home care aides who provide services for CHHAs, LTHHCPs or MCOs that are reimbursed in whole or in part by Medicaid must be reimbursed at no less than the minimum rate established according to the attached schedule. The living wage requirement applies to all dually eligible cases where Medicaid is the payer in part or in whole, including “split bill” cases.

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A Brief Wage Parity History

New York City Nassau, Suffolk , Westchester

March 1, 2012

Base: $9.00 Additional: Supplemental: $1.35 90% OT: $10.88

Base: Additional: Supplemental: OT: $10.88

March 1, 2013

Base: $ 9.50 Additional: Supplemental: $ 1.43 95% OT (until 12/31/13): $10.88

Base: $9.00 Additional: Supplemental: $1.35 90% OT (until 12/31/13): $10.88

March 1, 2014

Base: $10.00 Additional: $1.69 Supplemental: $2.40 100% OT (from 12/31/13): $12.00

Base: $9.50 Additional: Supplemental: $1.43 95% OT (from 12/31/13): $12.00

January 1, 2015

Base: $10.00 Additional: $1.69 Supplemental: $2.40 100% OT: $15.00

Base: $9.50 Additional: Supplemental: $1.43 95% OT: $14.25

March 1, 2015 SAME AS ABOVE

Base: $10.00 Additional: Supplemental: $2.40 100% OT: $14.25

March 1, 2016 SAME AS ABOVE

Lesser of: 115% of the total compensation of NYC; OR the total compensation mandated by the living wage law of Nassau, Suffolk or Westchester counties depending on episode of care location.

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What qualifies as Supplemental Wage?

NOT !

Statutory Benefits such as !

1. FICA

2. Statutory disability

3. Unemployment

4. Worker’s Comp

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What qualifies as Supplemental Wage?

๏ Always look at EMPLOYER cost!

๏ Always beware of refunds or dividends!

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๏ Health insurance (including self-insured plans)

๏ Advantage: QIVAPP qualifications require

๏ Health benefits OR

๏ Comprehensive health coverage

๏ $70 million in the pool

๏ Self-insured plans quality if meet actuarial value requirements

๏ Additional reimbursement may be from $0.30 to $1.00 per hour over

next couple of months

๏ Advantage: Higher wages sometimes cause employees to lose Medicaid

๏ Wage parity can keep employer and employee in ACA compliance

What qualifies as Supplemental Wage?

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Disadvantage: $2.40 per hour usually can’t match employees

current coverage

!$450-600 is minimum monthly premium for quality

insurance

What qualifies as Supplemental Wage?

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๏ Pension

๏ Dental

๏ Vision

๏ Medical FSA

๏ Life insurance

๏ Extended disability

๏ Critical injury

๏ PTO

๏ Transit checks (DOH silence…)

๏ Child care benefits

๏ Education subject to…

What qualifies as Supplemental Wage?

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Restrictions on Education Benefits

๏ Must primarily benefit the employee

๏ Not specific to the operations of the employer

๏ Attendance is voluntary

๏ Attendance is outside of regular hours

๏ Not directly related to job

๏ No productive work performed

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Structuring a Supplemental Wage Plan

I. Define your goals 1. wage parity compliance

2. ACA compliance

3. continuing coverage

4. employee satisfaction

5. reduce premium losses from terminates

II. Know your broker 1. infrastructure

2. experience

3. service

4. ACA upgrades/monitoring?

III. Reduce plan volatility

1. more worker satisfaction

2. less drain on payroll/HR staff

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A Quick ACA Review

Employers must provide all employees who work at least 30 hours a week or 130 hours a month with minimum essential health coverage that provides minimum value and is affordable to the employee. Affordable means for lowest cost of single plan employee would pay < 9.5% of his/her income. !Effective 1/1/15 for employers of 100 or more full time and full time equivalents.

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Warning!Plans may provide ACA MEC… (minimum essential coverage) !But not offer ACA MV (minimum value) != Employer at risk for penalties

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How Wage Parity Could Create ACA Problems?

ACA penalties only apply if employees seek insurance on the Exchange and receive a credit/subsidy.

!Employees with Medicaid (80%) may not turn to the Exchange BUT…

!If employees lose Medicaid primary coverage due to coordination issues with wage parity “bare bones” plans which don’t meet ACA requirements, you may be at risk for ACA penalties in 2016.

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What Do Your Employees Want?

1. Usually, cash supplements

2. Not to lose Medicaid (80% currently) ***

3. Plan stability

!An Offer They Can’t Refuse!

!*** If employee refuses benefits, you can ignore the refusal and still pay the premium instead of a cash supplement. It’s not necessary to report employee’s refusal.

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Issues with Varying Plans

๏ Generates employee confusion

๏ HR/Payroll staff fields questions, dissatisfaction

๏ ACA MV plans must stay constant for employee’s stability period (usually at least 6 months)

๏ Early hour-banking strategies: less common now

๏ Weekly plans: less common now

๏ For self-insured plans, once employee is out sick, loses benefits!

๏ Trend: base coverage on last month’s hours

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Volatility Reduction

1. Health plan coverage remains fixed

2. Use transit or child care, etc. to grant additional benefits as needed

3. Also good for 5 week months

!Example: Monthly premium costs employer $300

Employee works 130 hours.

Supplemental due = 130 x $2.40 = $312

Solution: Load $12 on transit card.

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What qualifies as Additional Wage?๏ Not overtime

๏ Vacation

๏ Sick

๏ Holiday

๏ Personal

๏ Shift or assignment differential/premium

๏ Accruals to meet NYC Sick Pay Law

๏ No tax relief as for supplemental wage

๏ 1199 Union: “state approved including some portion as supplemental wage”

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Safe-harbor Additional Wage Package๏ Annual leave: accrued at one hour for every 26 worked (up to 2.3 hours

per week and 10 days or 120 hours per year)

๏ Sick leave: accrued at one hour for every 26 worked (up to 2.3 hours per week and 10 days or 120 hours per year)

๏ Personal day: accrued at one hour for every 250 worked (up to 8 hours per year)

๏ Holidays: New Year’s Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Day

๏ Paid time off: when they fall on days that the employees are scheduled to work

๏ Premium pay: 1.5 times the base, when employees work on any of five holidays designated by the employer for premium pay

๏ Live-in work: an extra $16.95 per day, or $1.4125 per hour

๏ Weekend work: an extra $1.10 per hour

๏ Multiple clients: an extra $0.50 per hour

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Weighted Average of Differentials Allowed

!

total wage differentials paid to covered workers

divided by

total hours worked by covered workers

>= $1.69

!

If < $1.69, use PTO accruals to supplement

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What about Overtime?

1. No DOH guidance, even to NYSAHCP

2. PHI position: no wage parity for OT: $12.00

3. Some: Pay regular time wage parity: $14.09

4. Some: Pay OT + sup. + addit: $16.09

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Required Certifications

Annual reporting to DOH by

!a) CHHAs

www.health.ny.gov/health_care/medicaid/redesign/docs/wage_parity_att_a_2.pdf !

b) LTHHCPs www.health.ny.gov/health_care/medicaid/redesign/docs/wage_parity_att_a_3.pdf !

c) MCOs www.health.ny.gov/health_care/medicaid/redesign/docs/wage_parity_att_a_1.pdf

!๏ 10 year record retention requirement, audits and recouping possible ๏ List of subcontractors and their CBAs

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Required Certifications

Quarterly LCHSA reporting (even those with CBAs!)

to contracting agency (CHHA, LTHHCP, MCO)

!http://www.health.ny.gov/health_care/medicaid/redesign/docs/wage_parity_att_a_4.pdf

1. certification that attests to compliance

2. provide all information necessary to verify compliance

!10 year record retention requirement, audits and recouping possible.

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Coordination with CBAs

Terms which favor employee apply

!BUT

!If the CBA exempts employer from Supplemental Wage for employees who have never worked 80 hours for two months in a row, they are exempt from wage parity supplemental benefits also!

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Part II:

BDB’s Exclusive Wage Parity Solutions

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Introduction: PayStreamTM

๏ In-house developed and proprietary

๏ Fully customizable based on client need

๏ Web and remote apps – anywhere, anytime

๏ Advanced. rigorous data security

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1. Retroactive Overtime Calculations 2. Automatic Wage Parity Calculations 3. Automatic OT Calculations 4. Automatic Min Wage Calculations 5. Benefit Plan Data Transmission 6. HHA Software Integration 7. Education and Research Resource

Introduction: PayStreamTM

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Retroactive Overtime Calculations

๏ Track Date of service (charge date) controls

๏ Late time-sheets won’t disturb compliance

BDB Exclusive Feature 1:

Magda Johnson submits a timesheet for period ending 3/14/14 showing 39 hours worked. On 5/2/14, she remembers to report an additional home visit on 3/12/14 of 5 hours. BDB will automatically divide the 5 hours into 1 hour regular pay (40 - 39 previously reported hours) and 4 hours overtime pay and include the additional amount with her current paycheck.

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Automatic Wage Parity Calculations

I. Track wage parity liabilities employee by

employee for every hour worked based on

service

A) type

B) location

C) date

II. No manual calculations or spreadsheet tracking

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Automatic Wage Parity Calculations

BDB Exclusive Feature 2: !!James Brook reports hours and rates for the period ended 5/9/14 as follows. Note that although James is reporting 2013 service dates in 2014, BDB uses the wage parity rates and rules in effect for 2013 for calculating liabilities for those dates. Thus, for the 12/14/13 service date in NYC, no additional wage liability is computed and supplemental wage computations use the 2013 rates.

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Automatic Wage Parity Calculations

DOS Location Type of service

James’s Hourly Rate

BDB reports additional wage liability per hour

BDB reports supplemental wage liability per hour

5/5/14 NYC Medicaid $10.00 $1.69 $2.40

5/6/14 NYC Private $10.00 0 0

5/7/14 Suffolk Medicaid $10.00 0 $0.93

12/14/13 NYC Medicaid $10.00 0 $0.93

5/8/14 Nassau Medicaid $12.00 0 0

5/9/14 NYC Medicaid $11.00 $0.69 $2.40 ***

12/20/13 Westchester Medicaid $10.00 0 $0.35

BDB Exclusive Feature 2:

*** With BDB’s complete flexibility, you can choose to apply amounts in excess of base wage to supplemental wage before

additional wage. This chart shows the default setting of applying to additional wage before supplemental wage.

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Automatic Wage Parity Calculations

When wage parity rates change mid pay-period, BDB tracks hour by hour and saves you money, instead of lumping all hours together at the higher rates in effect at period end.

!BDB Exclusive Feature 3:

!The Helpers, a LHCSA, has a payroll period that ends on Wednesday. For the week ended March 5, 2014, Henry Gluck reports hours as follows. Henry’s default rate is set to wage parity settings.

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Automatic Wage Parity Calculations

DOS Location Type of service

Henry’s Hourly Rate

BDB reports additional wage liability per hour

BDB reports supplemental wage liability per hour

2/27/14 NYC Medicaid $9.50 0 $1.43

2/28/14 Nassau Medicaid $9.00 0 $1.35

3/3/14 NYC Medicaid $10.00 $1.69 $2.40

3/4/14 Nassau Medicaid $9.50 0 $1.43

3/5/14 NYC Medicaid $10.00 $1.69 $2.40

BDB Exclusive Feature 3:

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Automatic Overtime Calculations

!๏ Some popular time and attendance packages export

only total hours.

๏ BDB allocates hours appropriately between regular and overtime pay based on state wage and hour laws.

๏ If you have double time or premium rules, BDB calculates pay accordingly on an employee-by-employee basis.

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Automatic Overtime Calculations

Nelson Baker is a home health care worker. In New York. Your T&A software exports 45 hours for him for a workweek. BDB will automatically pay 40 hours at Nelson’s regular rate and 5 hours at his OT rate.

Deloris Caller is a live-in companion in New York. Your T&A software exports 45 hours for her for a workweek. BDB will automatically pay 44 hours at Deloris’s regular rate and 1 hours at her OT rate.

!Eleanor Davis is paid double time for hours in excess of 45. Your T&A software exports 47 hours for her for a workweek. BDB will automatically pay 40 hours at Eleanor’s regular rate, 5 hours at her OT rate and 2 hours at her double time rate.

BDB Exclusive Feature 4:

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Automatic Minimum Wage Calculations

๏ Date of service controls

๏ BDB uses minimum rates in effect for old service dates reported late

๏ BDB checks state of each service for required minimum wage

๏ Overtime will also be based on rates in effect on date of service

๏ No manual calculations or spreadsheet tracking

๏ BDB will override incorrect T&A package settings that may use higher,

current rates for old service dates

๏ You can set employee minimum rates with effective starting dates, to

ensure compliance with changing wage parity rates.

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Benefit Plan Data TransmissionBDB transmits supplemental liabilities directly to

!a) Insurance companies

b) Debit card programs

c) Transit card programs

d) All other benefit programs

!each payroll, or monthly using each provider’s specifications and saving you time and effort.

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Benefit Plan Data Transmission

BDB transmits census reporting for employee file changes as most insurance providers require.

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HHA Software Integration

๏ BDB integrates seamlessly with leading HHA software packages

๏ Ability to import:

✓ hours worked

✓ client names

✓ type of service

✓ date of services

✓ any other data items your software captures

๏ All imported items can also be included on employee pay stubs for ease of reference

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HHA Software Integration

BDB’s great relationships with HHA software vendors eliminate “finger pointing” and ensure speedy, painless issue identification and resolution.

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Education and Research Resource

BDB’s team of payroll specialist CPAs and CPPs are standing ready to help you solve your toughest wage parity issues.

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๏ Certificate of Course Completion will be emailed to registered address

!๏ To request alternate address, please email [email protected]

CPE Credit

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