Innovative Benefit Planning Blog

EEOC Updates Guidance Related to COVID-19 Workplace Testing

Posted On: January 19, 2023 | Categorized as: Compliance

In recognition of the changing circumstances related to the COVID-19 pandemic, the EEOC has updated its guidance around conducting testing for on-site employees. Employers covered by the Americans with Disabilities Act must assess whether the current workplace circumstances within their organization justify COVID-19 testing, if they are continuing to test.In determining if they meet the “business necessity” standard for implementing screenings, employers will need to review all relevant facts in light of their current policies and procedures. The guidance provides the following factors for employers to consider:Degree to which breakthrough infections are possible for employees who are “up to date” on vaccinationsThe possible severity of the illness from the current variantThe level of community transmissionThe vaccination status of employeesWhat types of contacts employees may have with others in the workplace; andThe potential impact on operations if an employee enters with COVID-19Many employers have already shifted their COVID-19 policies and procedures…


Biden Administration Enacts Speak Out Act

Posted On: January 19, 2023 | Categorized as: Compliance

Ahead of the close of the 117th U.S. Congress, the House of Representatives, with a vote of 315 – 109, quietly passed the Speak Out Act (“The Act”). President Biden signed the bill a few weeks later. Under the new law, nondisclosure and non-disparagement clauses related to allegations of sexual harassment and/or sexual assault that were entered into prior to a dispute are unenforceable. The goal of the Act is to combat sexual harassment and assault in the workplace by ensuring victims feel empowered to come forward. The Act states, “in order to combat sexual harassment and assault, it is essential that victims and survivors have the freedom to report and publicly disclose their abuse.” The Act only applies to contracts that were signed prior to the dispute and does not account for other workplace misconduct, e.g., race and age discrimination.Previously, the federal government enacted another law addressing similar concerns.…


The Secure Act 2.0 – Expanded

Posted On: January 17, 2023 | Categorized as: Retirement Plans

The Secure Act 2.0 - Expanded

The Secure Act 2.0 has been signed into law with the goal of promoting retirement security among Americans. The bill contains dozens of provisions that will impact various aspects of retirement plans. As a plan sponsor, it’s important to understand how the Secure Act 2.0 will impact your organization and employees. Below are several significant provisions contained within the legislationRequired Minumum Distribution ChangesThe required minimum distribution age increased to age 73, effective January 1, 2023. By 2033, the required minimum distribution age will be 75.The penalty for missing a required minimum distribution has been reduced from 50% to 25%. Catch-Up Contribution ChangesBeginning in 2025, participants between the ages of 60-63 can make catch-up contributions of up to $10,000 per year. The limit will be indexed to inflation.For employees with income greater than $145,000, Catch-Up contributions must be made on a Roth basis Increased Tax Credits To Offset Start-Up Costs For New PlansBeginning…


Continuing Appropriations Act Extends HDHP Relief for Telehealth Services

Posted On: January 9, 2023 | Categorized as: Compliance

President Biden last week signed the Continuing Appropriations Act, 2023 (CAA 23) to provide funding for the federal government through the current fiscal year. But employers also should know there were some critical benefits-related provisions tucked into CAA 23. Though many of the benefits sections of CAA 23 related to qualified retirement plans, the law also provides some relief to employers with high deductible health plans (HDHPs) that provide telehealth services on a pre-deductible basis. CAA 23 will extend recent COVID-19 guidance that permits certain telehealth and remote service benefits to be provided on a first-dollar basis under an HDHP. CAA 23 will allow participants to receive such benefits without disqualifying them from being eligible for health savings account (HSA) contributions. Telehealth Coverage and HSAs General HSA eligibility rules prohibit anyone who has group health coverage other than under an HDHP – such as first-dollar coverage for telehealth services --…


Feds Extend Prescription Drug Filing Deadline, Announce Relaxed Enforcement

Posted On: January 9, 2023 | Categorized as: Compliance

The Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) last week issued an FAQ that relieved filing entities from the December 27, 2022, deadline for providing certain information.The Departments understood many plans and carriers faced significant operational challenges in complying with the reporting requirements, including arranging and coordinating a plan’s submission across multiple reporting entities. The Departments also noted they were extending the deadline to allow filers to accurately classify, compile, and validate required submission data. The Departments will consider a plan or issuer to be compliant if they make a good faith submission of 2020 and 2021 data on or before January 31, 2023.Many interested parties also had expressed fears that the new and complex reporting requirements would inevitably lead to errors and other failures despite good faith efforts to comply.  So, for the 2020 and 2021 data submissions that were to have been…


Innovative Named A Samaritan Gala Honoree

Posted On: January 6, 2023 | Categorized as: Company News

Innovative Benefit Planning is honored to be recognized as a “2023 Celebration of Life Gala Honoree” at this year’s Samaritan Gala. Each year, Samaritan honors an individual and/or company for their continued passion, dedication, and love for Samaritan and the community. This year, Samaritan is recognizing Innovative for our commitment to community support.   Terriann Procida and Mark Sulpizio founded Innovative Benefit Planning believing the key to long-term relationships is doing what’s right for people. Volunteering and giving back have been incorporated into Innovative’s values since day one. Now, more than thirty years later, the Innovative team has become advocates for their clients and their community. The team has been active volunteers and supporters of Samaritan’s annual golf tournament, raffle, and more, the employees of Innovative Benefit Planning never fail to share their expertise, support, and time with Samaritan and a host of other community organizations. Innovative would like to…


Secure Act 2.0

Posted On: December 28, 2022 | Categorized as: Retirement Plans

The Secure Act 2.0 is poised to be signed into law with the goal of promoting retirement security among Americans. The bill contains dozens of provisions that will impact various aspects of retirement plans. As a plan sponsor, it’s helpful to understand how the Secure Act 2.0 will impact your organization and employees. Below are several major provisions contained within the legislation:RMD Age Increase Required Minimum Distribution age is increased to age 73 starting on January 1, 2023 and age 75 starting on January 1, 2033.Increased Catch-Up Limit to $10,000 for employees ages 60-64.Increased tax credits to offset start-up costs for new plans.Mandatory Automatic Enrollment and Automatic Escalation for new plans.Student Loan Payment Matching without hurting nondiscrimination testing.No Early Withdrawal Penalty for Emergency Withdrawals from a retirement plan.Long-Term Part-Time employees required eligibility reduced from 3 consecutive years with 500 hours of service to 2 consecutive years with 500 hours of…


Employers Prepare For Rx Reporting Deadline

Posted On: December 27, 2022 | Categorized as: Compliance

Section 204 of the 2021 Consolidated Appropriations Act (CAA) outlined several requirements for group health plans and health insurers aimed at targeting rising prescription drug costs. In an effort to bolster transparency, the CAA created new obligations for plans to report specific prescription drug data to The Centers for Medicare & Medicaid Services (CMS). Effective December 27, 2022, employer health plans will need to report certain information to the federal government related to prescription drug and health plan costs. In addition to reporting general information regarding the plan or coverage, plan and issuers must also prepare to provide, among other things, detailed information regarding the 50 most frequently dispensed drugs, 50 most costly and 50 prescription drugs with the greatest increase in plan expenditures (RxDC reporting). The provisions also require the Departments to issue biannual reports on prescription drug reimbursements under group health plans, prescription drug pricing trends and the…


Cafeteria Plans: Change in Status Events and Permissible Employee Election Changes

Posted On: November 30, 2022 | Categorized as: Compliance

Cafeteria plans are governed by IRS Code Section 125 and allow employers to help employees pay for expenses such as health insurance with pre-tax dollars. Employees can choose between a taxable benefit (such as cash) and two or more specified pre-tax qualified benefits (health insurance, for example). Employees can select the benefits they want, much like an individual standing in a cafeteria line. IRS rules limit the types of benefits that can be offered through a cafeteria plan to:Coverage under an accident or health plan (which can include traditional health insurance, health maintenance organizations (HMOs), self-insured medical reimbursement plans, dental, vision, andHealth flexible spending arrangements (HFSAs)Dependent care assistance benefits (DCAPs)Group term life insurancePaid time off, which allows employees the opportunity to buy or sell paid time off days401(k) contributions (subject to certain restrictions)Adoption assistance benefitsHealth savings accounts (HSAs)Employers cannot offer scholarships, group term life insurance for non-employees, transportation and other fringe…


Updated: Temporary Flexibilities for Remote Document Examination for Form 1-9 Extended

Posted On: October 28, 2022 | Categorized as: Compliance

Temporary Flexibilities for Remote Document Examination for Form I-9 Extended Again In March 2020, the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) instituted a temporary policy which allowed employers with a remote workforce to defer physical presence requirements associated with Form I-9 and Section 274A of the Immigration and Nationality Act. Initially applicable only to employers with an entirely remote workforce, the flexibilities were extended in April 2021 to include all employers who hire remote employees on or after April 1, 2021, if such employees were hired to exclusively work remote due to the employer’s COVID-19 policy. Under this guidance, exclusively remote employees are exempt from the physical inspection requirements until non-remote employment is undertaken, or new guidance around the requirements has been issued. Once normal operations resume or the National Emergency ends, employees that were onboarded using remote verification will need to report to…


“Family Glitch” Final Rule Released

Posted On: October 21, 2022 | Categorized as: Compliance

family glitch final rule released

Published October 13, 2022, The Department of Treasury released finalized regulations that make the premium tax credit (PTC) for Marketplace health coverage available to more individuals starting in 2023. Under the Affordable Care Act (ACA) regulations, employer-based health insurance is deemed “affordable” if the employee’s contribution for self-only coverage does not exceed the affordability threshold in a given year (9.12% in 2023). Those who do not have access to affordable employer-based coverage may qualify for a PTC through the healthcare marketplace. As a result of the previous definition of affordability, an estimated 5 million people fell into what is known as the “family glitch,” which prevented them from receiving a subsidy through the marketplace as the determination of whether the coverage met the affordability threshold is focused on self-only coverage, not family. Under the new rule, affordability of employer-sponsored coverage for an employee’s spouse or tax dependents will be based…


Health Plan Disclosure Requirements for Prescription Drugs

Posted On: September 29, 2022 | Categorized as: Compliance

health plan disclosure requirements

Under the Affordable Care Act (ACA) transparency-in-coverage (TiC) rules and provisions of the Consolidated Appropriations Act, 2021 (CAA), group health plan sponsors must both disclose and report detailed information regarding a plan’s prescription drug coverage and costs. There is significant overlap under the two sets of disclosure rules, which has led to confusion regarding compliance. The confusion is even greater since the rules impose two required components for prescription drug cost disclosure – an annual report (Report) to the Centers for Medicare & Medicaid Services (CMS) and a mandatory machine-readable file (MRF). The Report deadline was originally set for last year, but the Departments that enforce the rules delayed the deadline until December 27, 2022. Also, because there is significant overlap in the rules regarding prescription drug costs, the Departments delayed the prescription drug MRF requirement indefinitely pending further regulation and guidance. Recent CMS guidance provided some technical clarifications to…


Departments Issue No Surprises Act FAQ and Clarify Independent Dispute Resolution Process

Posted On: September 29, 2022 | Categorized as: Compliance

no surprises act FAQ

The U.S. Departments of Health and Human Services, Labor, and the Treasury (the “Departments”) recently released final rules regarding the No Surprises Act. The rules specifically address required independent dispute resolution (IDR) of certain claims and expenses and finalize prior interim final rules relating to information that group health plans must disclose. Federal IDR Process The No Surprises Act required regulators to develop an IDR process to resolve conflicts between payers and providers regarding out-of-network expense amounts. Any disputes unresolved after 30 days of negotiating can be referred by either side to binding arbitration from a certified IDR entity. The IDR entity will consider the qualified payment amount (QPA) – the insurance plan's median contracted rate for the same or similar service in an area – and other relevant submitted information, and then select one side’s suggested payment amount. Under interim final rules issued in October 2021, certified IDR entities…


Substantial Medical Loss Ratio Rebates Expected in 2022

Posted On: September 29, 2022 | Categorized as: Compliance

Per the Kaiser Family Foundation, an estimated 8.2 million Americans will be due rebates for 2022. Further the analysis states that health insurers are expected to pay a total of $1 billion to policyholders.  In light of this, plan sponsors should be prepared to handle any Medical Loss Ratio (MLR) rebates they receive from their insurance issuer in a manner that aligns with applicable rules. The Affordable Care Act (ACA) outlines the requirements private health insurance issuers must follow, including obligations related to premium spending. The ACA requires health insurers to spend at least 80% to 85%, depending on the size of the market, of premium dollars on medical care. The remaining 20% to 15% is reserved for administration, marketing expenses and profit. If these requirements are not met, plans are required to provide annual rebates to the policyholders, the Medical Loss Ratio (MLR) Rebates. These refunds or rebates are…


New Jersey Division on Civil Rights Enacts New Workplace Poster Requirements

Posted On: September 14, 2022 | Categorized as: Events

On August 1, 2022, the New Jersey Division on Civil Rights (DCR) adopted new and amended regulations around the “Display of Official Posters of the Division on Civil Rights.” New Jersey employers, housing providers and places of public accommodation are required to display posters to inform individuals and covered entities of their rights and obligations under the New Jersey Law Against Discrimination (LAD) and New Jersey Family Leave Act (NJFLA). The DCR has now released the revised posters that will need to be utilized to satisfy the requirements under the LAD. Additionally, employers with 30 or more employees who are covered by the NJFLA, will also need to replace their current NJFLA poster with the revised version. The revised posters must be prominently displayed in places easily visible to those who would be impacted by violations under the laws. Covered employers will also need to distribute the posters annually to…


Innovative Benefit Planning Receives Women’s Business Enterprise Owned Certification

Posted On: September 13, 2022 | Categorized as: Company News

Innovative Benefit Planning is proud to announce that The Women’s Business Enterprise National Council, has awarded Innovative Benefit Planning the national ‘Women’s Business Enterprise’ certification. “Empowering women in the workplace and acknowledging their contributions to everyday operations is not only important but extremely necessary,” said Terriann Procida, CEO. “Having a diverse team made up of not only women, but individuals from diverse backgrounds and cultures, has allowed us to bring an array of different perspectives to the table which adds to our growth, productivity, and so much more.” As the Chief Executive Officer and founding partner of Innovative Benefit Planning, Procida has worked endlessly to ensure the company embraces a commitment to diversity in the workplace. Fostering an inclusive environment is vital to the way the organization operates, which allows employees the opportunity to grow, feel accepted, and be challenged. Innovative employees see a representation of a variety of genders,…


Biden Administration’s Fiscal Year 2023 Budget Calls for Increased Enforcement for MHPAEA

Posted On: August 29, 2022 | Categorized as: Compliance

fiscal year 2023 budget

The Biden Administration’s FY 2023 proposed budget requests increased funds to enforce the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Specifically, the budget would allot $125 million to the states for MHPAEA enforcement. Additionally, President Biden requested an additional $275 million for the Department of Labor (DOL) to perform MHPAEA audits of group health plans over the course of the next 10 years. The proposed budget would also grant authority to the DOL to turn enforcement efforts toward the vendors who design and apply quantitative and non-quantitative treatment limitations (QTL and NQTL) for self-funded group health plans. Currently, the DOL’s authority is limited to the group plan sponsors under ERISA. This shift would allow the DOL to zero in on the parties responsible for the creation and administration of the play provisions, which are typically the plan’s carriers, instead of limiting the audit to the plan sponsor,…


President Biden Signs Inflation Reduction Act Into Law

Posted On: August 29, 2022 | Categorized as: Compliance

inflation reduction act

On August 16, 2022, President Biden signed the long-awaited Inflation Reduction Act which aims to reduce rising health care costs and greenhouse gas emissions, as well as raise taxes on corporations. The President’s signature comes after the House and Senate passed the bill last week along party lines following much debate and a deal negotiated between Senators Charles Schumer and Joe Manchin. Within the $430 billion dollar legislation there are several health care related provisions which target the prescription drug costs under Medicare, plan subsidies through the Marketplace, and as a result, a likely expansion for individual coverage health reimbursement arrangements (ICHRAs). A breakdown of the health care provisions is below. For a summary of provisions see here. Medicare Part D Prescription Drug coverage: Cost-sharing for insulin will be capped at $35 per month for Medicare Part D participants, and manufacturers will be required to pay Medicare a rebate if…


FDA Issues Final Rule Enabling Access to Over-the-Counter Hearing Aids

Posted On: August 22, 2022 | Categorized as: Compliance

hearing aids

Around 30 million adults in the U.S. deal with some form of hearing loss, but only an estimated 1 in 5 have addressed the issue with the use of a hearing assistance device. On August 16, 2022, the U.S. Food and Drug Administration (FDA) issued a final rule that would allow Americans to access hearing aids over-the-counter (OTC). The final rule creates a new category for OTC hearing aids, which will allow individuals with perceived mild to moderate hearing loss to purchase hearing aids directly in-store or online without prescription, medical exam or fitting by an audiologist. Prior to this, insurance coverage for hearing aids has been limited, with Medicare offering no coverage for individuals. This final rule is a result of legislation passed in 2017 by Congress (FDA Reauthorization Act of 2017) which required the FDA to create a category of OTC hearing aids and an Executive Order signed…


IRS Announces ACA Affordability Contribution Percentage for 2023

Posted On: August 5, 2022 | Categorized as: Compliance

ACA written on paper

The IRS announced a decrease in the ACA Affordability Contribution Rate from 9.61 in 2022 to 9.12 percent for the 2023 plan year, the most significant decrease since the ACA’s commencement. Under the ACA, Applicable Large Employers (ALEs), employers with 50 or more full time and/or full-time equivalent employees, are required to offer affordable minimum value coverage to all full-time employees and their dependents. The contribution percentage is used to determine whether the employer-sponsored health coverage is “affordable” under the ACA’s employer shared responsibility provisions. A plan will be considered affordable under the ACA if the employee’s contribution level for self-only coverage does not exceed the specified percentage of the employee’s household income. Failure to offer affordable coverage may result in employer shared responsibility penalties, which can be substantial. The IRS recognizes that it is difficult for an employer to determine an employee’s household income, so employers are able to…


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