FINAL FORMS FOR 2017 ACA REPORTING RELEASED

Click Here to Download the Full Article: Final Forms for 2017 ACA Reporting Released 10-5-17

On Sept. 28, 2017, the Internal Revenue Service (IRS) released final 2017 forms for reporting under Internal Revenue Code (Code) Sections 6055 and 6056.

  • 2017 Forms 1094-C and 1095-C (and related instructions) are used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
  • 2017 Forms 1094-B and 1095-B (and related instructions) are used by entities reporting under Section 6055, including self-insured plan sponsors that are not ALEs.

Final instructions for 2017 were released in early October. The 2017 forms are substantially similar to the 2016 versions, except that sections related to expired Section 4980H Transition Relief were removed.

ACTION STEPS

Employers should become familiar with the revisions to the forms, and prepare to file these final versions in early 2018.

Background

The Affordable Care Act (ACA) created reporting requirements under Code Sections 6055 and 6056. Under these rules, certain employers must provide information to the IRS about the health plan coverage they offer (or do not offer) or provide to their employees. Each reporting entity must annually file all of the following with the IRS:

  • A separate statement (Form 1095-B or Form 1095-C) for each individual who is provided with minimum essential coverage (for providers reporting under Section 6055), or for each full-time employee (for ALEs reporting under Section 6056); and
  • A transmittal form (Form 1094-B or Form 1094-C) for all of the returns filed for a given calendar year.

Reporting entities must also furnish related statements (Form 1095-B or 1095-C, or a substitute form) to individuals.

Forms must generally be filed with the IRS no later than Feb. 28 (March 31, if filed electronically) of the year following the calendar year to which the return relates. Individual statements must be furnished to individuals on or before Jan. 31 of the year immediately following the calendar year to which the statements relate.

2017 Forms and Instructions

The 2017 forms and instructions are substantially similar to the 2016 versions. However, note the following changes:

  • Section 4980H Transition Relief. Several forms of transition relief were available to some employers under Section 4980H for the 2015 plan year (including any portion of the 2015 plan year that fell in 2016). However, no Section 4980H transition relief is available for 2017. As a result, the 2017 instructions for Forms 1094-C and 1095-C were revised to remove references to Section 4980H transition relief. In addition, Form 1094-C has been revised to remove references to this transition relief. Specifically, the following two sections on Form 1094-C related to this transition relief have been designated as “Reserved” and should not be used: Part II, in the “Certifications of Eligibility” Section on Line 22, Box C; and Part III, in the “ALE Member Information – Monthly” table, column (e).
  • Instructions for Recipient. Both individual statements (Forms 1095-B and 1095-C) include an “Instructions for Recipient” section. On both of the 2017 Forms 1095-B and 1095-C, the following paragraph was added: “Additional information. For additional information about the tax provisions of the Affordable Care Act (ACA), including the individual shared responsibility provisions, the premium tax credit, and the employer shared responsibility provisions, see www.irs.gov/Affordable-Care-Act/Individuals-and-Families or call the IRS Healthcare Hotline for ACA questions (1-800-919-0452).”
  • Updated Penalty Amounts. Both sets of 2017 instructions include updated penalty amounts for failures to file returns and furnish statements in 2017. The adjusted penalty amount is $260 per violation, with an annual maximum of $3,218,500 (up from a maximum of $3,193,000, for 2016).
  • Code Series 2 (Section 4980H Safe Harbor Codes and Other Relief). The 2017 instructions for Forms 1094-C and 1095-C clarify that there is no specific code to enter on line 16 to indicate that a full-time employee who was offered coverage either did not enroll or waived the coverage.
  • Corrected Forms 1095-C. The 2017 instructions for Forms 1094-C and 1095-C include additional information for employers that have errors on Forms 1095-C. Specifically, the instructions indicate that Forms 1095-C filed with incorrect dollar amounts on line 15, Employee Required Contribution, may fall under a safe harbor for certain de minimis The safe harbor generally applies if no single amount in error differs from the correct amount by more than $100. If the safe harbor applies, employers will not have to correct Form 1095-C to avoid penalties. However, if the recipient elects for the safe harbor not to apply, the employer may have to issue a corrected Form 1095-C to avoid penalties. For more information, see Notice 2017-9.
  • Reporting Catastrophic Coverage for 2017. The 2017 instructions for Forms 1094-B and 1095-B clarify that reporting for catastrophic coverage enrolled in through the Exchange remains optional for 2017. It was expected that health insurance issuers and carriers would be required to report this coverage beginning in 2017. However, the instructions clarify that reporting of catastrophic coverage enrolled in through the Exchange will remain optional for coverage in 2017 (filing in 2018).
  • Formatting Returns Filed with the IRS. Both sets of 2017 instructions clarify that all returns filed with the IRS must be printed in landscape format.

In addition, a prior draft version of Form 1095-C for 2017 clarified that the “Plan Start Month” box in Part II of Form 1095-C will remain optional for 2017. The instructions for Forms 1094-C and 1095-C indicate that this box may be mandatory for the 2018 Form 1095-C.

Additional Resources

The 2016 versions of these forms are also available on the IRS website:

These forms must have been filed with the IRS no later than Feb. 28, 2017 (March 31, 2017, if filing electronically). However, the IRS extended the due date for furnishing individual statements for 2016 an extra 30 days, from Jan. 31, 2017, to March 2, 2017. The IRS does not anticipate extending the filing or furnishing deadlines for 2017 reporting.

According to the IRS, information returns under Sections 6055 and 6056 may continue to be filed after the filing deadline (both on paper and electronically). Employers that missed the filing deadline should continue to make efforts to file their returns as soon as possible.

The IRS also previously released:

More Information

Please contact Clark & Associates of Nevada, Inc. for more information on reporting under Code Sections 6055 and 6056.

Donating to Disasters and Avoiding Scams

Hurricane Harvey is the strongest storm to make landfall in the United States since Hurricane Charley in 2004. News of the damage it has caused to southeastern Texas is prompting people to help in whatever ways they can. Unfortunately, there are dishonest people who prey upon people’s good intentions, creating fake charity campaigns to exploit victims and take advantage of those who want to help.

How to Avoid Scams

Despite the sense of urgency to help when disaster strikes, it is important to do some research before donating. Consider the following best practices to ensure that your resources go to a legitimate charity with experience in disaster relief:

  • Never wire money to someone who claims to be a charity. Legitimate charities do not ask for wire transfers. Once you wire the money, you’ll probably never get it back.
  • Be cautious about bloggers and social media posts that provide charity suggestions. Don’t assume that the person recommending the charity has fully researched the organization’s credibility.
  • Only donate through a charity’s official website, never through emails. Scammers have a knack for creating fake email accounts that seem legitimate.
  • Ensure that the charity explains on its website how your money will be used.
  • Be wary of charities that claim to give 100 percent of donations to victims. That is often a false claim, as well-structured organizations need to use some of their donations to cover administrative costs.
  • Never offer unnecessary personal information, such as your Social Security number or a copy of your driver’s license. However, it is common for legitimate charities to ask for your mailing address, and it is safe for you to provide it.

How to Choose a Charity

Even legitimate charities need to be considered with care. The Federal Trade Commission suggests avoiding new charities because, despite their legitimacy, they may not have the resources needed to get your money to its intended recipients.

Donors looking for a worthy charity can access an unbiased, objective list on a website called Charity Navigator. The site receives a Form 990 for all of its charities directly from the IRS, so it knows exactly how the charities spend their money and use their donations. It also rates charities based on their location, tax status, length of operation, accountability, transparency and public support.

Gaining popularity for charitable donations is a crowdfunding website called GoFundMe, which allows people to raise money for a wide variety of circumstances. Despite its popularity, visitors to the site should be cautious about the campaigns to which they donate. Visitors can report suspicious campaigns directly to GoFundMe via its official website or to their state’s consumer protection hotline.

National Organizations

The following national organizations have long-standing reputations for providing disaster relief and accepting donations:

  • The American Red Cross provides shelter, food, emotional support and other necessities to people affected by disasters.
  • AmeriCares takes medicine and supplies to survivors.
  • Catholic Charities USA supports disaster response and recovery efforts that include direct assistance, rebuilding and health care services.
  • The Salvation Army provides shelter and emergency services to displaced individuals.

Remember that there are other ways to provide disaster relief that don’t involve monetary donations, especially if you live near the affected area. Local food banks and blood centers commonly ask for donations during relief efforts.

Donating to Disasters and Avoiding Scams

Financial Assistance Planning

Many people struggle with financial planning. Surveys reveal that as many as two-thirds of employees admit that worrying about their personal financial situations negatively affects their health. Stepping in with financial planning assistance as a voluntary benefit for your employees can help ease their stress, contributing to higher employee morale and productivity.

What Are Financial Planning Assistance Benefits?

Financial planning assistance benefits help employees better manage their finances, and this assistance can be offered in various formats:

  • Educational materials
  • Group seminar or presentation (in person or online)
  • Online class
  • Personalized advice through one-on-one counseling
  • Financial software
  • Financial calculators or budget templates

Financial planning assistance may be delivered individually or in a group setting. Advice and financial tools can be presented over the phone, in person or online.

There are different advantages for each type of financial planning assistance. Online classes, printed materials and group sessions are typically broadly applicable and could be a more efficient use of your company’s time and money.

However, individualized assistance may provide more value to your employees; when an employee sits down with a counselor in an individual meeting, the employee can receive information and advice specifically for his or her situation. Additionally, individual settings allow employees to ask personal financial questions without co-workers listening in.

How Do Financial Planning Assistance Benefits Work?

You can choose to provide financial planning assistance benefits from internal human resource or finance department personnel, or you could bring in experts from another organization. Third-party experts may be paid consultants, affiliates of your company or agents from a financial institution that agrees to provide counseling or seminars in exchange for the opportunity to promote their own services.

Consider having employees sign a statement that absolves you of any legal liability concerning advice given by the contracted financial planner. You don’t want to be liable if an employee loses money on an investment suggested by an advisor you provided access to.

Why Offer Financial Planning Assistance?

Easing the financial worries of your employees has multiple positive outcomes. By helping your employees with a major source of stress, you can increase morale. Further, studies suggest that financial worries can affect employees’ health and productivity, so you may gain healthier, more focused employees, saving money on lost or inefficient work time. Additionally, providing financial planning assistance benefits can contribute to your company’s corporate image.

Contact Clark & Associates of Nevada, Inc. for more information on offering your employees financial planning assistance as a voluntary benefit.

Click Here to Download the Full Document on Financial Planning

IRS CONFIRMS ACA MANDATE PENALTIES STILL EFFECTIVE

OVERVIEW

The Internal Revenue Service (IRS) Office of Chief Counsel has recently issued several information letters regarding the Affordable Care Act’s (ACA) individual and employer mandate penalties. These letters clarify that:

  • Employer shared responsibility penalties continue to apply for applicable large employers (ALEs) that fail to offer acceptable health coverage to their full-time employees (and dependents); and
  • Individual mandate penalties continue to apply for individuals that do not obtain acceptable health coverage (if they do not qualify for an exemption).

These letters were issued in response to confusion over President Donald Trump’s executive order directing federal agencies to provide relief from the burdens of the ACA.

ACTION STEPS

These information letters clarify that the ACA’s individual and employer mandate penalties still apply. Individuals and ALEs must continue to comply with these ACA requirements, including paying any penalties that may be owed.

Background

The ACA’s employer shared responsibility rules require ALEs to offer affordable, minimum value health coverage to their full-time employees or pay a penalty. These rules, also known as the “employer mandate” or “pay or play” rules, only apply to ALEs, which are employers with, on average, at least 50 full-time employees, including full-time equivalent employees (FTEs), during the preceding calendar year. An ALE may be subject to a penalty only if one or more full-time employees obtain an Exchange subsidy (either because the ALE does not offer health coverage, or offers coverage that is unaffordable or does not provide minimum value).

The ACA’s individual mandate, which took effect in 2014, requires most individuals to obtain acceptable health insurance coverage for themselves and their family members or pay a penalty. The individual mandate is enforced each year on individual federal tax returns. Individuals filing a tax return for the previous tax year will indicate, by checking a box on their individual tax return, which members of their family (including themselves) had health insurance coverage for the year (or qualified for an exemption from the individual mandate). Based on this information, the IRS will then assess a penalty for each nonexempt family member who doesn’t have coverage.

On Jan. 20, 2017, President Trump signed an executive order intended to “to minimize the unwarranted economic and regulatory burdens” of the ACA until the law can be repealed and eventually replaced. The executive order broadly directs the Department of Health and Human Services and other federal agencies to waive, delay or grant exemptions from ACA requirements that may impose a financial burden. However, the executive order does not include specific guidance regarding any particular ACA requirement or provision, and does not change any existing regulations.

IRS Information Letters

Office of Chief Counsel issued a series of information letters clarifying that the ACA’s individual and employer mandate penalties continue to apply.

  • Letter numbers 2017-0010 and 2017-0013 address the employer shared responsibility rules.
  • Letter number 2017-0017 addresses the individual mandate.
According to these letters, the executive order does not change the law. The ACA’s provisions are still effective until changed by Congress, and taxpayers are still required to follow the law, including paying any applicable penalties.

More Information

For additional information on the ACA Executive Order and the current tax filing season, please visit www.irs.gov/tax-professionals/aca-information-center-for-tax-professionals.

Click Here to Download the Full Article: IRS Confirms ACA Mandate Penalties Still Effective 8-3-17-1

Snapchat “Snap Map” Safety

What is Snap Map?

Introduced in a June 2017 update, Snap Map allows users to share their exact location with friends within the Snapchat app. Snap Map gathers location data using a smartphone’s GPS sensor and displays the time of day an individual is at a specific location and his or her speed of travel. This information is shown on a map that can be accessed when a user first opens Snapchat and pinches the screen to zoom out.

While Snapchat users can choose to share their location with selected friends, any posts users share on Snapchat’s “Our Story” feature will appear on the global map regardless of their privacy or location settings.

Concerns

Broadcasting one’s personal location might seem harmless, but there are potentially dangerous implications for your organization. Consider that many employees might use this feature in a way that compromises your business and take steps to mitigate this risk.

Inventory Protection

Employees shouldn’t use social media to post when they’re leaving for vacation, as this could leave their home vulnerable to robbery. The same risks are at play if employees use Snap Map to advertise their absence from work. Malicious individuals could seize the opportunity to steal or otherwise damage company property because they know it is unattended.

Company Perception

Employees who post on social media during business hours have tremendous control over your company’s reputation. Their thoughts and opinions are projected through the lens of the company, since they are on company—not personal—time. Even if employees do not mention your organization, their physical locations will be broadcast, offering that information anyway. Likewise, anywhere employees travel will be broadcast when they post, which could be compromising if they go to places that could make the company look bad.

Setting Expectations

Employees should be reminded of your company’s social media policy. Clearly lay out your organization’s expectations in the policy and communicate the potential dangers of this new social media feature.

User Tip

Share the following tip with employees or consider including it in your company’s social media policy.

  • Edit location settings. Click the gear icon in the Snapchat app. From there, scroll down to the “See My Location” tab and turn on “Ghost Mode.” This will prevent others from seeing your location.
Did You Know?
Snapchat is one of the top five social media platforms among young people, with approximately 150 million daily active users. While Snapchat is designed to be a fun photo, video and text messaging app, a number of features—particularly the Snap Map function—pose serious safety concerns.

For more information on how to protect your business on social media, contact Clark & Associates of Nevada, Inc. today.

Click Here for the full article on Snapchat Safety

Hiring Youth Workers

Youth Workers

Hiring youth workers—many times to fill seasonal positions—can be an integral component to your organization’s hiring plan. Early work experience can also be a great opportunity for teenagers to learn important skills.

To promote positive and safe work experiences, the U.S. Department of Labor (DOL) has a series of regulations relating to the employment of minors. These provisions are designed to protect young workers by restricting the types of jobs that they perform and the number of hours they work. It is important to follow all federal, state and local laws regarding the employment of minors to ensure that your business remains compliant and protects its reputation.

Listed below are some age-specific workforce regulations, as presented by the DOL’s YouthRules! initiative.

Rules for Workers Under 14 Years of Age

In general, youth workers who are under the age of 14 are limited on what type of jobs they can do. Workers who are under 14 years of age are only permitted to do the following jobs:

  • Deliver newspapers to customers
  • Babysit on a casual basis
  • Work as an actor or actress in movies, TV, radio or theater
  • Work as a homeworker gathering evergreens or making evergreen wreaths
  • Work for a business owned entirely by their parents as long as it is not in mining, manufacturing or any of the 17 hazardous occupations

There are different rules in place for minors in this age group who work in agriculture. States also have specific rules for youth workers under 14 years old, and employers must follow both.

Rules for Workers 14 to 15 Years of Age

Similar to workers under 14 years of age, youth workers who are 14 to 15 years old are limited on what types of jobs they can do and what hours they can work.

Job Restrictions

In general, youth workers within this age range are only permitted to do certain jobs, which include the following:

  • Work an approved retail position
  • Work an intellectual or creative position, such as computer programming, teaching, tutoring, singing, acting or playing an instrument
  • Run errands or complete delivery work by foot, bicycle and public transportation
  • Complete cleanup and yard work that does not include using power-driven mowers, cutters, trimmers, edgers or similar equipment
  • Work in connection with cars and trucks, such as dispensing gasoline or oil and washing or hand polishing
  • Work in a kitchen or the food serviceindustry reheating food, washing dishes, cleaning equipment or doing some limited cooking
  • Clean vegetables and fruits, wrap, seal, label, weigh pricing and stock items as long as these tasks are performed in areas separate from a freezer or meat cooler
  • Load or unload objects for use at a worksite including rakes, hand-held clippers and shovels

Additionally, 14- and 15-year-olds who meet certain requirements can perform limited tasks in sawmills and woodshops, and 15-year-olds who meet certain requirements can perform lifeguard duties at traditional swimming pools and water amusement parks.

If an occupation is not specifically permitted, it is prohibited for youth between the ages of 14 and 15.

Working Hour Restrictions

Workers who are 14 to 15 years old are also limited in what hours they can work. Generally, all work must be performed outside of school hours. In general, youth in this age range may not work the following:

  • More than three hours on a school day, including Friday
  • More than 18 hours per week when school is in session
  • More than eight hours per day when school is not in session
  • More than 40 hours per week when school is not in session
  • Before 7 a.m. or after 7 p.m. on any day, except from June 1 through Labor Day, when nighttime work hours are extended to 9 p.m.

A “school day” or “school week” for youth workers who are home schooled, attend private school or no school, is any day or week when the public school where they live while employed is in session. There are some exceptions to the hours standards for 14- and 15-year-olds if they have graduated from high school, are excused from compulsory school attendance, or are enrolled in an approved work experience, career exploration program or work-study program. Click here for more information on hours restrictions for youth workers in this age group.

Wage Requirements

In most cases, 14- and 15-year-olds must be paid the federal minimum wage, $7.25 per hour. Minimum wage eligibility varies depending on the type of job and location. Additionally, workers who are younger than 20 and eligible for the minimum wage may be paid as little as $4.25 per hour for the first 90 consecutive calendar days of their employment.

There are different rules for 14- and 15-year-olds working in agriculture and states also have rules, and employers must follow both.

Rules for Workers 16 to 17 Years of Age

Although there are no federal rules limiting the hours 16- and 17-year-olds may work, there are restrictions on the types of jobs they can do.

Job Restrictions

Workers who are 16 to 17 years old may work any job that has not been declared hazardous by the Secretary of Labor. Visit the YouthRules! webpage on workplace hazards for more information on banned occupations for workers under 18 years of age.

Wage Requirements

In most cases, 16- and 17-year olds must be paid the federal minimum wage, $7.25 per hour. Minimum wage eligibility varies depending on the type of job and location. Additionally, workers who are younger than 20 and eligible for the minimum wage may be paid as little as $4.25 per hour for the first 90 consecutive calendar days of their employment.

There are different rules for 16- and 17-year-olds working in agriculture and states also have rules, and employers must follow both.

Rules for Workers 18 Years of Age and Older

Once a youth worker turns 18, most youth work rules no longer apply. There are no limits to the number of hours or types of jobs an 18-year-old can work.

Wage Requirements

In most cases, 18-year-olds must be paid the federal minimum wage, $7.25 per hour. Minimum wage eligibility varies depending on the type of job and location. Additionally, workers who are younger than 20 and eligible for the minimum wage may be paid as little as $4.25 per hour for the first 90 consecutive calendar days of their employment. States also have rules, and employers must follow both.

Summary

Federal and state rules regarding young workers strike a balance between ensuring sufficient time for educational opportunities and allowing appropriate work experiences. Complying with these rules ensures that your organization is providing a safe work environment for teen workers to obtain appropriate early work experience.

 

Source: YouthRules! and the DOL

Click Here to Download the Article: Youth Workers

LIVE WELL WORK WELL – Surviving the Heat

SURVIVING THE SUMMER HEAT

Summer heat can be more than uncomfortable—it can be a threat to your health, especially for older adults and children. Whatever your age, do not let the summer heat get the best of you.

Heat Exhaustion

Heat exhaustion occurs when a person cannot sweat enough to cool the body, usually the result of not drinking enough fluids during hot weather. It generally develops when a person is playing, working, or exercising outside in extreme heat. Here are some symptoms:

  • Dizziness, weakness, nausea, headache and vomiting
  • Blurry vision
  • Body temperature rising to 101°F
  • Sweaty skin
  • Feeling hot and thirsty
  • Difficulty speaking

A person suffering from heat exhaustion must move to a cool place and drink plenty of water.

Heat Stroke

Heat stroke is the result of untreated heat exhaustion. Here are some symptoms:

  • Sweating
  • Unawareness of heat and thirst
  • Body temperature rising rapidly to above 101°F
  • Confusion or delirium
  • Loss of consciousness or seizure

Heat stroke is a serious medical emergency that must be treated quickly by a trained professional. Until help arrives, cool the person down by placing ice on the neck, armpits and groin. If the person is awake and able to swallow, give him or her fluids.

Tips for Staying Cool

Below are some tips for staying safe in the heat:

  • Drink plenty of waterIn hot weather, drink enough to quench your thirst. The average adult needs eight 8-ounce glasses of water a day—more during heat spells.
  • Dress for the weatherWhen outside, wear lightweight clothing made of natural fabrics and a well-ventilated hat.
  • Stay inside if possibleDo errands and outside chores early or late in the day.
  • Eat lightReplace heavy or hot meals with lighter, refreshing foods.
  • Think cool! Take a cool shower or apply a cold compress to your pulse points. Try spending time indoors at an air-conditioned mall or movie theater.

Click Here to download Surviving the Summer Heat

Electronic Distribution of ERISA Disclosures

Click Here to download the full document: Electronic Distribution of ERISA Disclosures

Department of Labor (DOL) regulations contain a safe harbor under which employee plans may use electronic means to distribute certain documents and other information required under the Employee Retirement Income Security Act of 1974 (ERISA). For example, summary plan descriptions (SPDs), summaries of material modifications (SMMs), summary annual reports (SARs), COBRA notices, qualified domestic relations orders (QDROs) and qualified medical child support orders (QMCSOs) can all be distributed electronically if certain conditions are met.

The Affordable Care Act (ACA) created additional disclosure requirements for group health plans and employers, such as the summary of benefits and coverage (SBC) and a notice about the ACA’s health insurance Exchanges (Exchange Notice). The SBC and the Exchange Notice may be distributed electronically if certain requirements are met.
This Compliance Overview provides general information regarding electronic disclosure requirements for ERISA plans.

What type of disclosures can a plan administrator send electronically?

The DOL’s safe harbor regulations allow plan administrators to electronically send disclosures required under Title I of ERISA. These disclosures include:

SPDs and SMMs QDRO and QMCSO notices
COBRA notices SARs

Also, employers that satisfy the DOL’s safe harbor requirements may distribute the Exchange Notice electronically. As described in more detail below, a different set of rules applies for electronic distribution of the SBC to participants and beneficiaries. In general, these rules make it fairly simple for the SBC to be provided electronically to participants and beneficiaries in connection with their online enrollment or online request for an SBC.

The requirements for sending documents electronically do not change any standards regarding who is entitled to a disclosure, the content of the disclosure or the timing of the disclosure.

DOL safe harbor for electronic disclosure

May plan administrators electronically distribute ERISA disclosures to all recipients?

The regulations contain guidelines for providing disclosures to: (1) employees with work-related computer access; and (2) other plan participants and beneficiaries who consent to receive disclosures electronically.

Employees with Work-related Computer Access

ERISA disclosures may be delivered electronically to employees that:

  • Have the ability to effectively access documents furnished in electronic form at any location where the employees are reasonably expected to perform their duties; and
  • Are expected to have access to the employer’s electronic information system as an integral part of those duties.

Merely providing employees with access to a computer in a common area (for example, a computer kiosk) is not a permissible means to electronically furnish ERISA-required documents.

Beneficiaries and Other Plan Participants Who Consent to Receive Disclosures Electronically

A plan administrator must obtain written consent prior to electronically delivering ERISA disclosures to beneficiaries and other plan participants who do not have work-related access to a computer. The consent may be received in either electronic or paper form.

Prior to consenting, an individual must be given a clear and conspicuous statement that explains:

  • The types of documents to which the consent will apply;
  • That consent can be withdrawn at any time without charge;
  • The procedures for withdrawing consent and for updating the address used for receipt of electronically furnished documents;
  • The right to request and obtain a paper version of an electronically furnished document, including whether the paper version will be provided free of charge; and
  • Hardware or software needed to access and retain the documents delivered electronically.

Where the electronic distribution is made through the internet, the individual must affirmatively consent in a manner that reasonably demonstrates his or her ability to access information in the electronic form that would be used.

If the plan administrator changes its hardware or software requirements, it must provide a new notice and obtain new consent.

What General Disclosure requirements apply to all electronic disclosures?

Plan administrators are required to use measures reasonably calculated to ensure actual receipt of the material by plan participants and beneficiaries. The regulations provide some guidance on what measures are reasonably calculated to ensure actual receipt when electronic delivery is used.

Notice

A notice must be sent either electronically or in paper form to each plan participant or beneficiary at the time the document is provided electronically.

The notice must: ·     Indicate the significance of the document when it is not otherwise reasonably evident as transmitted; and

·     Explain the participant’s right to request a paper copy.

Confirmation of Receipt

The plan administrator must make use of electronic mail features such as return-receipt or notice that the email was not delivered. The plan must also conduct periodic reviews to confirm receipt of the transmitted information.

Confidentiality

When personal information pertaining to an individual’s benefits or accounts is transmitted electronically, steps must be taken to protect the confidentiality of the information.

Style, Format and Content Requirements

Documents delivered electronically must continue to be furnished in a manner consistent with the applicable style, format and content requirements contained within ERISA. For example, summary plan descriptions provided electronically must contain all the disclosures otherwise required by ERISA’s disclosure requirements. The DOL has indicated that the appearance of paper and electronic versions need not be identical.

Paper Copy

Plan participants and beneficiaries are entitled to receive a paper copy of any ERISA disclosure provided electronically. Where a plan participant or beneficiary requests a paper copy of a document originally provided electronically, the general rules governing whether a plan administrator may or may not charge for paper copies apply.

Can benefit and claim determinations be provided electronically?

Yes. The regulations provide that benefit and claims determinations related to a specific individual may be communicated electronically to that individual. However, where the information contained within the communication is confidential in nature or protected health information subject to the HIPAA Privacy Rules, the plan administrator must take appropriate and necessary steps to ensure that the information remains confidential.

What forms of electronic disclosure are permissible?

The regulations do not require the use of any specific form of electronic media. Examples of permissible forms of electronic disclosure include delivery of documents by email, attachment to an email, or posting documents on a company website.

May a plan administrator electronically deliver ERISA notices by placing the information on a company website?

Under the guidelines contained within the regulations, merely placing an SPD on a company website available to employees will not by itself satisfy ERISA’s disclosure requirements. The plan administrator must also send a notice, either electronically or in paper form, that notifies the employee that the SPD is available on the website.

A plan administrator that intends to distribute SPDs, SMMs and SARs electronically might do the following:

  • Post SPDs, SMMs and SARs on a company website available to all employees;
  • Obtain consent to electronically deliver SPDs, SMMs and SARs from employees and COBRA participants who do not have regular work-related computer access. For example, employees working for a manufacturer in the plant may agree to access the website from their home computers;
  • Send an email notice to all employees who have work-related computer access or who have provided consent each time an SPD, SMM or SAR is posted on the website, using email features such as return receipt and notice of non-delivery;
  • Continue to provide in paper form copies of SPDs, SMMs and SARs to employees who do not have regular work-related computer access and who have not provided consent; and
  • Continue to provide in paper form copies of SPDs, SMMs and SARs upon request free of charge.

Note: The plan administrator is generally not required to distribute SPDs, SMMs or SARs to each beneficiary under the plan. Therefore, the plan administrator is not required to obtain consent from each beneficiary under the plan (for example, spouses and dependent children).

May a plan administrator electronically deliver COBRA notices by placing the information on a company website or sending them via email?

Yes, the rules allow plan administrators to provide COBRA notices electronically.

However, because COBRA notices must be provided via first-class mail to the home address where a spouse or dependent is also covered under the plan, the plan administrator must obtain consent from the spouse or dependent before delivering COBRA notices electronically. Therefore, providing COBRA notices electronically may not be as practical as electronically delivering SPDs, SMMs or SARs.

Do special rules apply to the SBC?

The SBC must be provided by a group health plan or issuer to participants and beneficiaries in connection with enrollment and renewal and upon request. It may be provided in either paper or electronic form (such as by email or an internet posting). The requirements for electronic delivery of the SBC generally depend on whether the SBC is provided in connection with an online enrollment or under other circumstances.

Also, the uniform glossary is a separate document that is a companion to the SBC. The SBC must include an internet address for obtaining the uniform glossary, a contact phone number to obtain a paper copy of the uniform glossary and a disclosure that paper copies are available.

Online Enrollment

On June 16, 2015, the DOL and the Departments of Health and Human Services and the Treasury (Departments) published new final regulations on the SBC. These final regulations adopt a safe harbor for the electronic delivery of the SBC in connection with online enrollment. The Departments first adopted this safe harbor in 2012 through a series of Frequently Asked Questions (FAQs) on ACA implementation.

Under this safe harbor, the SBC may be provided electronically to participants and beneficiaries in connection with their online enrollment or online renewal of coverage under the plan. SBCs also may be provided electronically to participants and beneficiaries who request an SBC online. In either case, the individual must have the option to receive a paper copy upon request.

Other Circumstances

If the online enrollment safe harbor does not apply, the final regulations contain two rules for electronic distribution of the SBC. These rules may apply, for example, if a plan does not have an online enrollment system or if the plan allows paper or telephone enrollment in addition to online enrollment.

Individuals Covered under the Plan

The SBC may be delivered electronically to participants and beneficiaries who are already covered under the group health plan if the DOL’s safe harbor for electronic disclosure is satisfied.

Eligible Individuals Not Enrolled

For participants and beneficiaries who are eligible but not enrolled for coverage, the SBC may be provided electronically if:

  • The format is readily accessible;
  • The SBC is provided in paper form, free of charge, upon request; and
  • If the electronic form is an internet posting, the plan or issuer timely notifies the individual in paper form (such as a postcard) or email that the documents are available on the internet, provides the internet address and notifies the individual that the documents are available in paper form upon request.

In the 2012 FAQs, the Departments provided, as an example, the following language to meet the requirement to provide a postcard or an email to inform employees of the SBC’s availability. Plans have flexibility with this language and may choose to tailor it in many ways.

Clark & Associates provides these services at no extra charge to our valued clients, saving employers valuable time and money.

Please call us at 775-828-7420 or contact us if you have any questions pertaining to ERISA docs or compliance.

 

House Passes Changes to Overtime Rules

Click Here to download the full article: House Passes Change to Overtime Rules

OVERVIEW
On May 2, 2017, the House of Representatives passed the Working Families Flexibility Act (also known as H.R. 1180). If approved, H.R. 1180 would authorize private employers to offer compensatory time instead of overtime pay for nonexempt employees who work more than 40 hours per week. H.R. 1180 still needs approval from the Senate and the executive branch before it becomes law.
Compensatory time off is already a common practice for many federal and state employers, but it is not currently allowed by the Fair Labor Standards Act (FLSA) for private employers. H.R. 1180 would amend the FLSA to allow this practice, if certain conditions are met.
ACTION STEPS
Because H.R. 1180 is not yet law, no action steps are currently required of any employers.
This Compliance Bulletin is provided for informational purposes only, to assist employers in understanding the changes H.R. 1180 would bring to current overtime compensation practices in the private sector.

Compensatory Time Off
Currently, the FLSA requires employers in the private sector to pay overtime wages to nonexempt employees for all hours of overtime worked. If approved, H.R. 1180 would amend the FLSA to allow private sector employers to provide either overtime pay or compensatory time off to nonexempt employees who work overtime hours.
H.R. 1180 is proposing that compensatory time off be calculated at the rate of 1.5 hours of compensatory time off for every hour of overtime work. As it stands, H.R. 1180 would expire within five years of its enactment. In addition, the bill would limit the amount of compensatory time off eligible employees may receive to 160 hours.
H.R. 1180 would only apply to private sector employers, meaning that if it were to be adopted, it would not affect current compensatory time off requirements for public sector employees.
Voluntary Agreement and Usage
Under H.R. 1180, both employers and employees would have to agree to compensatory time off instead of overtime wages. In unionized environments, compensatory time off would have to be allowed by any applicable collective bargaining agreement. The agreement would need to be preserved in writing and take place before any compensatory time off begins to accrue.
Finally, the language of H.R. 1180 would prohibit employers from coercing or forcing employees to agree to receive or use compensatory time off instead of overtime wages. This means that employers would not be allowed to directly or indirectly intimidate, threaten or coerce (or attempt to intimidate, threaten or coerce) employees to agree to receive or use any accrued compensatory time off.
Eligibility
Under H.R. 1180, employees would be eligible to receive compensatory time off after 1,000 hours of continuous employment during the previous 12 months.
Payment for Unused Compensatory Time
H.R. 1180 would require employers to allow employees to use any earned compensatory time off within a reasonable period, as long as this does not unduly disrupt the employer’s operations.
However, employers would be required to provide monetary compensation to their employees for any compensatory time off that is not used by the end of the calendar year, although employers would be able to determine a different 12-month period as long as it remains consistent.
Unused compensatory time would need to be paid at a rate that would at least be equal to the employee’s regular wage rate. The employee’s regular rate would be the higher of:
The regular wage rate at the time the overtime work was performed; or
The regular wage rate at the time the unused compensatory time off must be paid.
Payment for unused compensatory time off would be required within a month of the end of the 12-month period.
More Information
We will continue to monitor the progress of this bill through the legislative process and update you as more information becomes available. In the meantime, contact Clark & Associates of Nevada, Inc. for more information regarding the FLSA and overtime wage payment requirements at 775-828-7420 or email us with your questions or concerns.

 

Specialty Drug Benefits Overview

Specialty drugs (or specialty pharmaceuticals) are the most expensive prescriptions you can buy—around $1,000 or more per month. Unfortunately, they are also the only option for many people who have complex, and otherwise untreatable, conditions.

What are Specialty Drugs?

Specialty drugs are expensive prescription medications that are used to treat chronic, complex conditions. Individuals suffering through cancer, multiple sclerosis or rheumatoid arthritis might be prescribed a specialty drug.

Special handling—like refrigeration and supervised injections—is often required for these medications, contributing to the high costs. Patients who need a specialty drug are usually monitored before and after it is administered to check for side effects and treatment progress.

 

 

Are Specialty Drugs Covered?

Whether a specialty drug is covered depends on your benefits plan. A

specialty drug could be covered under medical or prescription drug insurance. How the drug is administered often determines which benefit covers the medication. For instance, self-injections at home might place it under prescription drug insurance, whereas supervised injections in a clinic might place it under medical insurance.

What Do I Pay?

Specialty drug costs are steadily rising and projected to reach around $400 billion by 2020, according to UnitedHealth Group. In 2016, the United States spent about $121 billion on specialty drugs. Similarly, specialty drug spending is predicted to surpass traditional pharmacy spending by 2018, according to the National Business Group on Health (NBGH).

Specialty drug costs are steadily rising and projected to reach around $400 billion by 2020.

Due to the high costs of these prescriptions, many benefit plans include a separate tier for specialty drugs. The tier specifies how much an individual must pay for the specialty medication. For instance, the specialty drug tier would differ from what you pay for normal prescriptions. Your plan will determine if you pay a flat copay or a percentage of the specialty drug costs.

Where Can I Find Help?

Your doctor is the first person you should speak with regarding lower specialty drug costs. It is possible there are more affordable alternatives to your prescription or there is an option that would treat multiple conditions.

If you have any questions about your specialty prescriptions being covered under your benefits plan, please speak with HR or call us at 775-828-7420 to review your options.

Click Here for the Full Article: Specialty Drug Benefits Overview