The Patient Protection and Affordable Care Act requires health care flexible spending accounts (FSAs) to limit salary reduction contributions to $2,500 beginning January 1, 2013. Presently, health FSAs are not subject to an annual contribution limit, although employers typically design their plans to impose a contribution maximum.
Q.- I am continuing my group health plan coverage under COBRA. When I turn age 65, can I keep my COBRA coverage?
HR or Benefits Administrators who leave employment or change roles within an organization should be removed from access to not only HR systems, but also to the systems of vendors, including BAS. MyEnroll.com provides a comprehensive resource for managing employee demographics and benefits data. As such, BAS stores personal information such as Social Security Numbers, dates of birth, mailing address, and in the case of Flexible Spending Accounts, limited claims information. While BAS stores all such data securely in compliance with HIPAA, allowing a former Administrator's log-on information to remain active after the employee no longer has a legitimate business reason for accessing the data places the company and individual employees' data at risk.
Increasingly, employers are turning to social media for recruiting and as part of their overall business operations strategy. Consulting social media can provide an insight into an applicant's or employee's personality and judgment sense, and could serve as an inexpensive alternative or supplement to formal background checks.
Q.- I purchased contact lens solution and bandages at my local drug store. I know over-the-counter medicines must be prescribed to be reimbursed from my FSA. Can I get reimbursed for the bandages and contact lens solution, or do I need a prescription for these items?
Employers who currently hand-key new employee records into multiple systems, such as a Human Resource Information System (HRIS), Payroll System and MyEnroll.com, risk data entry errors as well as increased human capital. Payroll/HRIS Import and Export Services from BAS can eliminate redundant data entry, reducing errors and time.
The Office of Civil Rights is taking steps to enforce HIPAA compliance. The first OCR audits began in November 2011, and uncovered compliance issues, at a cost to covered entities. Most audits to date have been aimed at health care providers; however, health plans, particularly large health plans, are also at risk. The following three factors may play a role in if a group health plan will be selected for audit.
The Supreme Court's decision on the constitutionality of health care reform is expected within weeks. Whatever the outcome of the decision, it is very likely that some provisions of health care reform that have already been implemented, such as age 26 coverage and elimination of lifetime limits, will probably be here to stay.
More employers are outsourcing benefits than ever before. Benefits outsourcing is a desirable alternative for many companies, particularly those companies in the mid to large-size market. Health care reform concerns and the complexities of compliance are cited as reasons for the increase in benefits outsourcing among organizations.
Q.- I am working for a company that established business on February 2, 2012. The company has 50 employees. If I am terminated from group health plan coverage in December, will I be offered the right to continue my coverage under COBRA?
BAS remains vigilant about keeping client data private and secure. Toward that end, BAS practices several best practices to ensure that communications are made only to intended recipients. All employers may benefit from some of BAS' standard practices.
BAS' insurance "Self-Billing" service makes it easy for employers to pay their group life, short-term disability, and long-term disability premiums to their carriers. The Self-Billing service consolidates all covered employees into coverage-specific reports that meet each insurer's specific reporting requirements. Typically, the Self-Billing reports will either be structured as (1) List Reports or (2) Volume Reports.
The Employee Benefits Security Administration issued additional guidance on the new Summary of Benefits and Coverage (SBC) that must be distributed beginning September 2012 in accordance with the Affordable Care Act. The SBC is intended to enable consumers to easily understand their health coverage and determine the best health insurance options for themselves and their families. All health plans will provide a Summary of Benefits and Coverage, along with a uniform glossary of terms, to enrollees upon request and before they buy coverage. The SBC must meet specific format requirements, and the Department of Labor released a format SBC as a template for use. Please refer to our prior blog article for a general discussion of the SBC.
The IRS announced new inflation-adjusted Health Savings Account (HSA) contribution limits and High Deductible Health Plan (HDHP) limits for 2013. The new limits reflect cost-of-living adjustments permitted under the Internal Revenue Code.
All MyEnroll.com users, including both administrators and individual employees, are assigned a unique user ID and password. The user ID and password are required to access the MyEnroll.com on-line enrollment and benefits portal.
Employers sponsoring group health plans that offer prescription drug coverage to individuals eligible for Medicare Part D (generally those age 65 and older, including active employees, retirees, COBRA participants, and dependents) must disclose to those individuals whether the group health plan coverage is creditable or non-creditable. Prescription drug coverage is considered creditable for Medicare Part D purposes if the employer's coverage is, on average, at least as good as standard Medicare prescription drug coverage. To make this determination, the employer must determine if the plan's actuarial value equals or exceeds the actuarial value of standard Part D coverage.
Health care reform requires the Department of Health and Human Services (HHS) to issue a series of regulations to streamline health care administration and make existing electronic health care transactions work more efficiently. This health care reform requirement is based on Congress recognizing that there is a need for a consistent framework for electronic health care transactions. The Health Insurance Portability and Accountability Act (HIPAA) was the initial attempt at streamlining health care transactions. The Affordable Care Act expanded on several of HIPAA's administrative simplification requirements.
Q.- My doctor suggested that I get a massage to help my lower back pain. Can I get reimbursed from my health FSA for the cost of the massage?
Employees can quickly and easily set up direct deposit ACH authorization for flexible spending accounts through MyEnroll.com. Direct Deposit is available for FSA participation regardless of whether an employer authorizes direct deposit for payroll purposes. ACH allows FSA reimbursements to automatically be deposited into an approved checking or savings account on Tuesdays when claims are processed and reimbursed. Instead of a check being mailed by USPS mail when it is authorized, the funds will be immediately deposited in the authorized account. This feature allows participants to receive reimbursement for eligible expenses more quickly.
The Health Insurance Portability and Accountability Act (HIPAA) requires an "authorization" for any use or disclosure of protected health information that is not specifically permitted by the privacy rule. The privacy rule specifically allows the use and disclosure of PHI for treatment, payment and health care operations.
Q- We have an Employer Group Waiver Plan (EGWP) with a wrap that supplements CMS Medicare prescription drug coverage. Should we offer a COBRA coverage election for the wrap portion of the EGWP?
Federal law does not clearly prohibit an employer from asking about arrest and conviction records in the pre-employment or employment context. However, the Equal Employment Opportunity Commission issued enforcement guidance on an employer's use of arrest and conviction records for making employment decisions.
The Internal Revenue Service issued a notice describing potential approaches for determining if employer group health coverage provides minimum value for purposes of health care reform. Beginning in 2014, eligible individuals who buy coverage under a qualified health plan through an Exchange may receive a tax credit to help make the coverage purchased through the Exchange more affordable. An employee who is eligible to enroll in an employer plan is not eligible for the tax credit unless the plan's coverage is either unaffordable or does not provide minimum value. An employee is also not eligible for the credit if the employee actually enrolls in the employer plan, even if the plan is not affordable or fails to provide minimum value. A large employer (with over 50 employees) will be assessed and required to pay a penalty if any of the employer's full-time employees receives a premium tax credit through an Exchange. The premium tax credit is not available, and therefore the employer will not be subject to the penalty, if the employer offers the employee affordable group health coverage meeting certain standards.