This week, the buzz in the health care reform world has been the upcoming opening of the Exchanges on October 1. From long-winded talks in Congress to cheery commercials on television, consumers and businesses alike are anxiously awaiting a much anticipated aspect of health care reform.
The Department of Labor released two final rules aimed at improving the hiring and employment of disabled individuals and veterans. The rules amend the Vietnam Era Veterans’ Readjustment Assistance Act of 1974 (VEVRAA) and Section 503 of the Rehabilitation Act of 1973. Both rules impact employers who engage in federal contracting.
VEVRAA prohibits federal contractors and subcontractors from discriminating against veterans and places responsibilities on such employers to actively recruit, hire, promote and retain veterans. The new rule gives some substance to VEVRAA by requiring contractors to establish annual hiring benchmarks for protected veterans. The rule provides two methods for establishing benchmarks. The rule also adds a data collection requirement, along with a requirement to offer employees and job applicants the opportunity to self-identify veteran status.
Q.- An employee is asking to enroll her same-sex spouse in coverage. She just went to Connecticut and got married over the weekend. Our business is in Pennsylvania, and she lives in Pennsylvania. Do we have to allow her spouse to enroll in our health plan?
Employers should be gearing up to distribute the newly required Health Care Marketplace Notice to all employees by October 1, 2013.
Changes to the HIPAA Privacy Rule released in January 2013 as part of the Omnibus Final Rule require all plan sponsors to enter into agreements with their business associates who have access to protected health information of their group health plan. These agreements must be in place by September 23, 2013.
Q.- For my health flexible spending account plan, what is the difference between a Letter of Medical Necessity and a Prescription?
Even though the effective date for the employer mandate to offer health coverage to all employees or pay a penalty has been delayed, employers still must pay attention to reporting requirements under health care reform. The Affordable Care Act requires employers to report to the government statistics on their health insurance offerings. Last week, the government released guidance that is intended to ease employers’ reporting obligations.
The employer mandate requires employers with 50 or more full-time employees to provide affordable health coverage or pay a fine per worker after the first 30 employees. Employers subject to the mandate must file a return with the IRS indicating, among other things, the number of full time employees and certain information about health coverage offered to those employees. The new proposed guidance provide that employers will report the following information:
- The name, address and EIN of the employer; the name and telephone number of a contact person; and the calendar year of the information;
- Certification as to whether the employer offered to full time employees and their dependents the opportunity to enroll in minimum essential coverage;
- The number of full time employees for each month during the calendar year;
- For each full time employee, the months during the calendar year for which coverage under the plan was available;
- For each full time employee, the employee’s share of the lowest cost monthly premium for coverage offered to the employee by calendar month;
- The name, address and TIN for each full time employee during the calendar year and the months if any during which the employee was covered under the plan.
The Department of Labor has clarified its Family Medical and Leave Act (FMLA) rules in light of the decision in Windsor giving spousal rights to same-sex marriage. The DOL revised guidance to confirm that an employee may be eligible for FMLA leave to care for a same-sex spouse or for activities related to a same-sex spouse’s military service. The guidance, in the form of an updated Q&A on its website, defines “spouse” for FMLA purposes as a husband or wife as defined or recognized under state law for the purpose of marriage in the state in which the employee resides (including same-sex marriage).
Since the FMLA rules reference state law for defining marriage, FMLA leave for an employee in a same-sex relationship only has to be offered if the employee is married to the same-sex spouse and the employee resides in a state that recognizes same-sex marriage.
Q.- One of our employees was on family coverage and terminated employment. The entire family elected to continue coverage under COBRA. The employee’s daughter had a baby and wants to add the baby to her COBRA coverage. If the daughter were covered as a dependent under our active plan, she would not be allowed to add the baby. Can she add the baby under COBRA?
A.- Yes. The baby may be added to COBRA coverage. When the family unit elected to continue coverage under COBRA, each person covered under your plan on the day before the qualifying event is a COBRA qualified beneficiary in his or her own right. As a COBRA qualified beneficiary, the individual has the same rights as active employees. An active employee could add a baby to coverage, Therefore, the child continuing the coverage under COBRA can also add her baby to coverage.
Final regulations on the Individual Mandate under health care reform were issued last week. Health care reform requires virtually all Americans to be enrolled in minimum essential health coverage or pay a penalty on their tax return. While the employer mandate to offer health coverage was delayed a year, the individual mandate is effective January 1, 2014.
Last week, the U.S. Department of Treasury and the Internal Revenue Service issued a ruling widening the recognition of same-sex marriage for tax purposes. This ruling has implications for employers who may have to change payroll systems, notice processes, and benefit offerings to comply with the new rule.