DOL Health Plan Audits Underway

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Employers who sponsor health plans for their employees must be prepared to pass a health plan audit by the U.S. Department of Labor (DOL), recent reports indicate. Since 2009, the DOL has hired hundreds of new auditors to bring increased scrutiny to employer compliance with various laws and regulations. The first areas of emphasis revolved around wage and hour and employee classification issues, but with implementation of the Affordable Care Act nearly complete, health plans are receiving increased attention. The ...

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EEOC Wellness Lawsuits Highlight Tension Between ACA, ADA

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Between August and October 2014, the U.S. Equal Employment Opportunity Commission (EEOC) filed three lawsuits against employers in Minnesota and Wisconsin over their workplace wellness programs. The EEOC claims that the programs violated the Americans with Disabilities Act (ADA), while the employers argue that their practices are specifically authorized by the Affordable Care Act (ACA).

Employers and HR professionals are watching the cases closely because workplace wellness programs are increasingly common, and the rules surrounding them are unclear. A 2014 Mercer ...

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Survey Shows Strong Employer Interest in Health Benefits, Private Exchanges, and Independence

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Independence

A recent survey of over 400 employers reveals that employers are committed to offering health benefits to active employees, and that interest in private exchanges remains strong. In addition, the vast majority of employers surveyed reported that it is very important for their advisors to be independent of any exchange ...

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More Employers Covering Maintenance Meds at 100%

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More employers are treating maintenance medications, like those treating cholesterol or blood pressure, as a preventative prescription which is eligible for 100% coverage in high deductible health plans.  Typically, these prescriptions would be subject to the individual or family deductible, and the consumer would pay the entire cost of the medications until the deductible is met.  However, IRS 223(c), exempts preventative health care and prescriptions from the deductible in a high deductible health plan.  This lack of clarity regarding the definition of a ...

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SCOTUS Decision Looms Over 2015 Benefit Strategies

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On November 7, the U.S. Supreme Court agreed to hear another challenge to the Affordable Care Act. In 2012, the Court upheld the constitutionality of the law’s requirement that individuals obtain health insurance or pay a penalty and limited the Federal government’s ability to withhold funding for states that did not expand eligibility for Medicaid. This new case is perhaps not as significant as the 2012 case, but employers should still be aware of how its outcome could affect their ...

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2015 Public Exchange open enrollment begins Saturday

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Public exchange open enrollment will begin on Saturday November 15 for both individual and SHOP plans on healthcare.gov. The Public Exchanges allow for direct comparisons of qualified health plan (QHP) options on the basis of price, quality and other factors. QHPs are grouped into four “precious metal” tiers based on their actuarial value: platinum, gold, silver, and bronze. The Public Exchanges also coordinate eligibility for subsidies such as premium tax credits and cost-sharing reductions.

The first public exchange open ...

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Employees in Cafeteria Plan Can Move to Exchanges Mid-Year

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Until recently an employee participant in a cafeteria plan could only make mid-year changes to their elections within the plan if it fell within specific exception.  Previously, there was no exception allowing an employee to drop employer-sponsored health insurance coverage to purchase health insurance on a public exchange as part of the Affordable Care Act mid-year.

IRS Notice 2014-55 now includes language specific to employee participation in public exchanges.  An employee participant in a cafeteria plan can change their cafeteria plan election mid-year if the ...

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Status Quo Health Plans Put Employers at Cadillac Tax Risk

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More than half of employers with 5,000 or more employees could be liable for the Cadillac Tax in 2018 if no plan design changes are made to lower the cost of health benefits according to a recent study by Towers Watson. The study projects 48% of those employers will be liable in 2018 and 82% in 2023.  This analysis assumes a medical trend of 7% annually.

The Cadillac Tax is a 40% excise tax on health benefits costing more than $10,200 ...

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Employers taking steps to drive health plan value

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Employers are continuing to take steps to get the most value out of their employee health plans. Responses from the 2014 Towers Watson/NBGH Employer Survey on Purchasing Value in Health Care show that the best-performing employers are acting aggressively to improve their health plan cost trend and also help employees manage their well-being. Steps taken by employers include establishing coverage tiers based on the number of covered dependents, modifying health ...

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EEOC Wasn’t Kidding-Another ADA & GINA Lawsuit

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The EEOC prioritized barriers to recruitment and hiring and emerging issues (like GINA) within its 2013-2016 enforcement plan.  This latest lawsuit is a step towards that goal.

Cummins Power Generation of Shoreview, MN was recently sued by the EEOC for violating the American’s with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).  Cummins required an employee to sign various medical release forms before taking a fit-for-duty exam.  The employee was told to sign the medical releases or face termination. ...

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