Health FSA Plan Changes

Beginning with the 2015 plan year, you will be able to carry over up to $500 of your remaining Health FSA funds from one year to the next. This carryover provision replaces the two-and-a-half month grace period currently in place for the Health FSA. The grace period for the 2014 plan year will not change.

You may carry over funds from plan year to plan year as long as you are an active UC employee and eligible to participate in the Health FSA—even if you do not re-enroll.

Under the new provision, you may carry over up to $500 to the following year, even if you do not re-enroll for the next plan year. However, the carryover funds will not be available to use until after the run-out period, which ends on April 15, 2016. This gives you time to submit 

reimbursement requests for eligible expenses incurred during the previous plan year. If you have funds remaining after the run-out period closes, up to $500 will be credited to your account automatically. You will lose any funds in excess of $500.

California Enacts Paid Sick Leave Law

On September 10, 2014, Governor Jerry Brown signed a new law into effect, entitled the "Healthy Workplaces, Healthy Families Act of 2014," making California only the second state in the country (after Connecticut) to require employers to provide paid sick leave for its employees.  The state law follows the recent enactment of a paid sick leave law in San Diego that goes into effect on April 1, 2015.

OVERVIEW OF CALIFORNIA'S PAID SICK LEAVE LAW

Key features of the Healthy Workplaces, Healthy Families Act of 2014 are as follows: 

• Beginning July 1, 2015, employees working in California for 30 or more days within a year are entitled to accrue paid sick days at the rate of at least one hour per every 30 hours worked, beginning as of their hire date (or July 1, 2015, if later).
• Employees will be able to begin using their accrued paid sick days beginning on their 90th day of employment, after which they may use paid sick days as they are accrued, up to a maximum number of 24 hours, or 3 days per year.
• Employees may use paid sick leave for their own health condition as well as the health condition of a family member (defined as spouse, registered domestic partner, grandparent, grandchild, and sibling). In addition, the employee can use leave if he or she is a victim of domestic assault, sexual violence, and/or stalking.
• Accrued paid sick days are carried over to the following year, but do not need to be paid out at termination. Employees who are rehired with a break in service of less than one year are entitled to have previously accrued and unused paid sick days reinstated.  
• Certain employee groups are exempt, including those covered by a collective bargaining agreement that meets specific requirements, providers of in-home health care, and certain individuals employed in the airline industry who are compensated with time off equal to or exceeding the amount provided under this law.
• The law is intended to provide minimum requirements pertaining to paid sick days. An employer that currently provides paid sick leave, is permitted to (but is not required to) provide more paid sick days than what is required under this law.
• Employers must track sick leave accrued and used for each employee. Records must be kept for at least 3 years. There are also notice (see below) and posting requirements.

Notice Requirements

Each employee must be provided a notice at the time of his or her hiring containing information deemed material and necessary, including the following:

• Pay rate information.
• Meal, lodging and other allowances claimed as part of the minimum wage (if any).
• The employee's regular pay day (as designated by the employer).
• Employer name and contact information (including address and telephone number).
• Name and contact information of the employer's workers' compensation insurance carrier.
• A statement to the effect that the employee may accrue and use sick leave, has a right to request and use accrued paid sick leave, may not be retaliated against for doing so, and has the right to file a complaint against an employer that does retaliate against him or her.

It is also contemplated that the Division of Labor will provide a model notice to satisfy these requirements.

SAN DIEGO'S EARNED SICK LEAVE AND MINIMUM WAGE ORDINANCE

California's paid sick leave law comes on the heels of the passage of the "Earned Sick Leave and Minimum Wage Ordinance" in San Diego. Effective April 1, 2015, the Ordinance generally requires employers of all sizes to accrue up to an hour of paid sick leave for every 30 hours of paid work performed in the City of San Diego. However, it permits employees to use up to a maximum of 40 hours (5 days) of sick leave versus 24 hours, or 3 days, a year under the state law. In addition, the Ordinance raises the minimum wage in the City annually from $9.75 per hour effective January 1, 2015 to $11.50 per hour effective January 1, 2017 (and beginning January 1, 2019, the minimum wage will be indexed to inflation).

San Francisco also has a paid sick leave ordinance that permits eligible employees to accrue paid sick leave for every 30 hours of work. Up to 72 hours may be accrued annually (40 hours for employers with fewer than 10 employees), with no cap on how much paid sick leave an employee may use in a year.

90 Day Waiting Period

Senate Bill (SB) 1034 was signed into law on August 15, 2014 by California Governor Jerry Brown and will go into effect on January 1, 2015.

Previously, California had established a 60-day waiting period while the ACA had established a 90-day waiting period.

This new law means that California's health coverage waiting period requirements are now better aligned with federal law, which translates to less confusion with respect to the provisions of the Affordable Care Act (ACA). As of today, we have been advised of the following information from our carrier partners:

Carriers who do not intend to change their current available options:

• Aetna
• CaliforniaChoice®
• CalCPA
• CoveredCalifornia™
• Sharp Health Plan
• UnitedHealthcare

Carriers who are still pending a decision:

• Anthem Blue Cross
• Chinese Community Health Plan
• Health Net
• Kaiser Permanente
• SeeChange Health

How Does Your Charter School Stack Up?

Discovery Benefit Solutions has made a name for itself by helping charter schools find savings in their healthcare plans. Please fill out the following information and we’ll email you the 2014 benchmarking data detailing the medical, dental, and vision benefits compiled from over fifty Southern California Charter schools.

Final Regulations Implementing Employer and Insurer Reporting Requirements Released

On March 5, 2014, the Internal Revenue Service (IRS) and the U.S. Department of the Treasury finalized the two proposed regulations on the Affordable Care Act (ACA)'s employer and insurer reporting requirements to provide information to the IRS and to covered individuals about the health plan coverage they offer (or do not offer) to their employees. These requirements are found in Internal Revenue Code (Code) sections 6055 and 6056, and are intended to provide the IRS with information to administer other ACA requirements - in particular, the employer and individual mandates. They will also allow individuals to establish verification of their coverage to determine if they will qualify for a premium tax credit in the Health Insurance Marketplace (Marketplace).   BACKGROUND: REQUIREMENTS OF CODE SECTIONS 6055 AND 6056 Code section 6055 requires health insurance issuers, self-insured health plan sponsors, government agencies that administer government-sponsored health insurance programs (for example, Medicare, Medicaid, CHIP or TRICARE), and any other entity that provides minimum essential coverage (MEC), to file an annual report with the IRS about the type and period of coverage offered. Code section 6056 requires all large employers that are subject to the employer mandate to report certain health care coverage information offered to their full-time employees to the IRS. Both Code section 6055 and 6056 also require reporting entities to furnish a statement annually to individuals enrolled in MEC (Code section 6055) and full-time employees (Code section 6056). Among other things, this information will be used to determine whether employees can claim a premium tax credit on their tax returns for coverage purchased through the Marketplace. Proposed regulations were published on September 9, 2013 that provided guidance on implementing the reporting requirements under Code sections 6055 and 6056, including providing options for potentially simplifying the reporting process. The March 5, 2014 final regulations adopt the proposed regulations, but also make some amendments in taking into consideration comments received with respect to some of these proposed options. FINAL REGULATIONS Key features of the regulations are described below. Information Reporting Requirements Specific information required by Code Section 6055 includes information about the entity offering coverage, including contact information, the name and taxpayer identification number (TIN) for each individual enrolled in coverage, and the months for which they were covered. A covered individual's date of birth will also be required, but only if a TIN is not available after reasonable efforts have been made to obtain it. Specific information required to be reported under Code section 6056 includes the following: Information about the employer offering coverage, including contact information, and the calendar year for which the information is being reported A certification as to whether the employer offered MEC to its full-time employees (and their dependents), by calendar month The number of full-time employees by calendar month A list of full-time employees, along with contact information for each employee For each full-time employee, the months during the calendar year for which MEC was available, and information about the coverage offered to each, including the employee's share of the lowest cost monthly premium for self-only coverage providing minimum value that was offered, by month In an effort to streamline and simplify the reporting process, some of the above information will be reported through the use of indicator codes. In addition, the final rules omit data elements in the statute that are not necessary to understanding coverage offered and provided, including (but not limited to) the following: The length of any waiting period The employer's share of the total allowed costs of benefits provided under the plan The amount of advance payments of the premium tax credit and cost-sharing reductions Employers are also given the option to avoid identifying which of its employees are full-time, and instead to just include in the report those employees who may be full-time. To take advantage of this option, the employer must certify that it offered affordable, minimum value coverage to at least 98 percent of the employees on whom it is reporting. In addition, in furtherance of the effort to streamline the reporting process, alternative methods of reporting are available, as described below. Single Combined Form for Information Reporting to IRS Permitted The final rules provide for a single, consolidated form that employers will use to report to the IRS and employees under both Code sections 6055 and 6056, thereby simplifying the process and avoiding duplicative reporting. The combined form will have two sections: the top half includes the information needed for Code section 6056 reporting, while the bottom half includes the information needed for Code section 6055. Employers that are large enough to be subject to the employer responsibility provisions and that "self-insure" will complete both parts of the combined form for information reporting Employers that are subject to employer responsibility but do not "self-insure" will complete only the top section of the combined form (reporting for Code section 6056). Insurers and other providers of health coverage will report only under Code section 6055, using a separate form for that purpose. Insurers do not have to report on enrollees in the Marketplace, since the Marketplace will already be providing information on individuals' coverage there Simplified Option for Employer Reporting under Code Section 6056 For employers that provide a "qualifying offer" to any of their full time employees, the final rules provide a simplified alternative to reporting monthly, employee-specific information on those employees. A qualifying offer is an offer of minimum value coverage that provides employee-only coverage at a cost to the employee of no more than about $1,100 in 2015 (9.5 percent of the Federal Poverty Level), combined with an offer of coverage for the employee's family For employees who receive qualifying offers for all 12 months of the year, employers will need to report only the names, addresses, and TINs of those employees and the fact that they received a full-year qualifying offer. Employers will also give the employees a copy of that simplified report or a standard statement indicating that the employee received a full-year qualifying offer  For employees who receive a qualifying offer for fewer than all 12 months of the year, employers will be able to simplify reporting to the IRS and to employees for each of those months by simply entering a code indicating that the qualifying offer was made To provide for a phase-in of the simplified option, employers certifying that they have made a qualifying offer to at least 95% of their full-time employees (plus an offer to their families) will be able to use an even simpler alternative reporting method for 2015. Those employers will be able to use the simplified, streamlined reporting method for their entire workforce, including for any employees who do not receive a qualifying offer for the full year. Those employers will provide employees with standard statements relating to their possible eligibility for premium tax credits EFFECTIVE DATE Employers that have fewer than 50 full-time employees are exempt from the ACA employer shared responsibility provisions and therefore from the employer reporting requirements. The information returns must be filed with the IRS by February 28 (or March 31, if filed electronically) of the year following the calendar year coverage was offered. The first Code section 6055 and 6056 reporting returns will be due in 2016 for coverage provided in 2015. Reporting for the 2014 calendar year is voluntary. The individual statements for each calendar year must be furnished to all responsible individuals enrolled by January 31 of the next calendar year. Extensions of this deadline may be available in certain circumstances. The first employee statements (meaning the statements for 2015) must be furnished no later than February 1, 2016 (as January 31, 2016 falls on a Sunday). Source: (Burnham Benefits)

Obama Delays Health-Care Mandate for Some Companies

A batch of employers won’t face a fine next year if they fail to provide health insurance to their workers, the Obama administration said Monday.

In regulations outlining the Affordable Care Act, the Treasury Department said employers with between 50 and 99 full-time workers won’t have to comply with the law’s requirement to provide insurance or pay a fee until 2016.

Companies with 100 workers or more could avoid penalties in 2015 if they showed they were offering coverage to at least 70 percent of their full-time workers, the Treasury said.

The move is a new, significant revision of the law after a series of delays and a troubled rollout. Originally, employers with the equivalent of 50 full-time workers or more had to offer coverage or pay a penalty starting at $2,000 per worker beginning in 2014.

That so-called employer mandate was seen as a cornerstone provision in the law’s goal of expanding insurance coverage to millions of Americans this year. But last summer the administration announced a surprise one-year reprieve in enforcement of the requirement, from 2014 to 2015.

Monday’s announcement of further delays comes as the administration weighs how much of the law to adjust in the wake of the rollout and the looming prospect of midterm elections.

A senior administration official said the shift reflects the administration’s observations on the law’s implementation and its willingness to acknowledge business concerns, though the official said that no single reason was behind the change.

Most large employers offer coverage to their workers, though not all employees accept it. Many of the companies that don’t offer coverage have fewer employees and are in lower-wage areas such as the hospitality, retail and agriculture sectors. They have been among the most vocal about the impact of the new requirements.

Some of those employers had begun trimming workers’ hours as a way to reduce their exposure to penalties, since the requirement to cover workers only applies to employees clocking 30 hours a week or more.

The administration also signaled on Monday that big employers that currently offer coverage voluntarily will likely see simpler requirements for how to prove that. However, full regulations detailing the reporting requirements haven’t been released, senior Treasury officials said.

Under the new rules, companies would be allowed during the phasing-in year to offer coverage specifically to a subset of employees, such as those working 35 hours or more a week, the Treasury said.

Senior Treasury officials said the shift was aimed at giving more time for smaller employers subject to the requirement to adjust and for all companies to consider the number of hours their employees worked and whether they could avoid cutting them.

The officials said employers who wanted to use the phase-in period would have to certify that they hadn’t decreased their employee numbers in order to qualify.

Treasury also set new rules for how the requirement would apply to workers such as volunteers and seasonal employees, saying that employers wouldn’t be penalized for failing to offer those people coverage, regardless of the number of hours they were working.

In recent months the administration has made a series of changes to the law that have further blunted its full impact this year. It has asked insurers to temporarily reinstate policies that had been canceled because they didn’t meet new requirements set by the law, even though the administration had previously described those plans as inadequate.

The botched launch of online insurance portals also prompted the Congressional Budget Office to revise its estimates for the number of people who would use the exchanges this year to 6 million, as well as another 8 million people who would gain coverage by signing up for Medicaid.

Wall Street Journal, Monday, February 10, 2014
By Louise Radnofsky

The Company That solved Health Care March 19th

Join Discovery Benefit Solutions as we host John Torinus, Chairman, twenty year CEO of Serigraph, and author of, "The Company That Solved Health Care" for a seminar that will change how you think about your company's health plan. Serigraph began its initiative to control healthcare costs in 2003, when its annual healthcare bill was $5 million and another $750,000 was needed for the projected 15 percent annual increase. The company employed three strategies for reform, each of which has the potential to cut your company's healthcare bill by 20 percent. Applied in concert with other management methods, these three approaches almost eliminated the growth in healthcare costs at Serigraph while improving the quality of employee care. The results are documented. They are beyond refute. This complimentary event is for C-Suite, HR personnel, and Benefit Administrators managing plans with one hundred or more employees. Discovery Benefit Solutions specializes in transitioning employers from fully insured to self-funded benefit plans. Registration is limited to two hundred. This event has been approved for 1.00 (Specific) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. Discovery Benefit Solutions is a full service employee benefit brokerage firm specializing in the negotiation, implementation, and ongoing management of self-funded and fully insured group benefit programs. Areas of additional expertise include cost reduction strategies through full claims reporting data, pharmacy benefit management renegotiation, and wellness programs.