Innovative Benefit Planning Blog

HHS Releases Guidance on Exchanges, Including Draft Exchange Blueprint and Rules for Federally Facilitated Exchanges and SHOPs

Posted On: June 13, 2012 | Categorized as: Company News, Employee Benefits, Health Care Reform

HHS has issued a flurry of guidance on Exchanges, including a draft blueprint for use by states establishing an Exchange, and an outline of the agency's approach to implementing a federally facilitated Exchange (FFE) and federally facilitated Small Business Health Options Program (FF-SHOP) in states that do not establish a state-based Exchange. Here are highlights from some of the recent guidance: • FFEs and State Partnership FFEs In states without a state-based Exchange, HHS will establish an FFE and perform all Exchange functions including plan management functions (such as certifying, recertifying, and decertifying QHPs) and consumer-assistance functions (such as providing consumer assistance in determining individual eligibility for enrollment and insurance affordability programs, including advance payment of the premium tax credit and cost-sharing reductions). The guidance explains that a state may, however, choose to establish a state partnership FFE which permits the state to administer plan management functions and/or consumer assistance…

Final Regulations Address Individual Tax Credit for Coverage Purchased Through Exchange

Posted On: June 13, 2012 | Categorized as: Company News, Employee Benefits, Health Care Reform

The IRS has published final regulations addressing various aspects of the premium tax credit enacted as part of health care reform. The final regulations address a number of technical issues affecting eligibility for and calculation of the tax credit. Here are some highlights of significance for employer-sponsored plans: • Guidance on Determining Tax Credit Eligibility As a general rule, if an eligible employer-sponsored plan meets the two conditions (affordability and minimum value), merely being eligible for the plan will make an employee ineligible for the tax credit. The regulations clarify that an eligible employee who declines enrollment in such a plan remains ineligible for the tax credit for each month in the coverage period related to the enrollment period (e.g., for the full plan year in the case of an annual enrollment period). As a corollary to the general rule, if an employee actually enrolls in an eligible employer-sponsored plan,…

HHS Makes Available Calculator to Assist in Preparing Coverage Examples for SBC

Posted On: June 12, 2012 | Categorized as: Company News, Health Care Reform

As indicated in recent agency FAQs regarding the summary of benefits and coverage (SBC) requirement under health care reform, the Department of Health and Human Services (HHS) has made available a model coverage examples calculator, and related instructions and algorithm, to assist plans and insurers in preparing the required coverage examples for the SBC.  (The coverage examples component of the SBC is intended to estimate what proportion of expenses under an illustrative benefits scenario might be covered by the plan, to allow a covered individual to make a comparison of his or her share of the costs under different plan options.) The model calculator is intended as a transitional tool for plans and insurers to use as a safe harbor to complete the coverage examples in a streamlined fashion for the first year of applicability.  According to HHS, although this approach will be "less accurate," it will give plans and…

Borzi Announces Fee Disclosure Help for Participants

Posted On: June 12, 2012 | Categorized as: Company News, Retirement Plans

June 11, 2012 --- Phyllis Borzi, assistant secretary for the Employee Benefits Security Administration (EBSA), announced tools to help participants understand fee disclosures. --- In her retirement security newsletter for plan participants, Borzi said the EBSA offers consumer-focused FAQs that explain the new rules for disclosures about 401(k) services and investment fees. In addition, the agency has a publication, A Look at 401(K) Plan Fees, which includes explanations of various fees and charges and a checklist participants can use to review plan fees. The consumer-focused FAQs are here. The publication can be seen here.

Water Precautions for the Backcountry

Posted On: June 6, 2012 | Categorized as: Company News, Workplace Wellness

On day hikes, safe drinking water usually isn't an issue. You can carry what you need. But longer, overnight adventures are another story. When planning a camping trip, it is important to anticipate your water needs. There are many approaches you can take to providing yourself and others in your group with safe water for drinking. While the water flowing in the streams and rivers of the backcountry may look pure, it can still contain bacteria, viruses, parasites and other contaminants. Wildlife, pack animals and messy humans all have the potential to contaminate water sources. Do not drink untreated water from lakes, rivers, springs, ponds, streams or shallow wells. Note -- if a wild animal drinks from a water source, that does not mean that the water is safe for you to drink. What are the best ways to treat water to make it safe for drinking? Boiling is the…

IRS Eases Health Care Reform Law’s $2,500 Limit for Noncalendar-Year FSAs:

Posted On: May 31, 2012 | Categorized as: Company News, Health Care Reform

The IRS on Wednesday provided regulatory relief for health care flexible spending account (FSA) participants and also said it is reconsidering its longtime use-it-or-lose-it rule for FSAs. Employer benefits lobbying groups, including the American Benefits Council (ABC) had complained that the new $2,500 annual limit set to go into effect on January 1, 2013 would effectively force noncalendar-year plans to comply with the rule before the statutory effective date.  For example, an employee in an FSA with a fiscal year that begins on July 1, 2012, elected to contribute $3,600 during that plan year, making contributions of $300 a month from July 1, 2012, through June 30, 2013.  If the employee elects to contribute $2,500 for the next plan year starting July 1, 2013, the employee would violate the $2,500 annual limitation for 2013, the ABC noted, because the employee would have contributed $300 a month for the first six…

Thomas Mangan Joins UBA As New CEO

Posted On: May 25, 2012 | Categorized as: Company News, Employee Benefits

The UBA Board has selected Thomas Mangan, an insurance industry leader with more than 20 years of experience in the employee benefit marketplace, to serve as chief executive officer, effective immediately. As announced at UBA's Spring Meeting earlier this week, Thom will take over the role and duties of Bill Howell, UBA's president, who is retiring after nearly 10 years of service to the organization. Most recently, Thom served as a regional president for USI Insurance Services, one of the eight largest insurance brokerage firms in the nation. Thom also has worked as president of the employee benefits division of HUB International Limited and as South-Central employee benefits practice leader at Willis. Thom has served on a number of advisory boards and councils, such as the Council of Employee Benefit Executives, the Industry Affairs Committee and on the national consultant advisory boards of several carriers, including CIGNA, Aetna and UnitedHealthcare.…

Innovative Attends the 2012 Community Access Unlimited Golf Outing

Posted On: May 25, 2012 | Categorized as: Company News, Employee Benefits, Retirement Plans

Elizabeth, NJ – May 11, 2012 – While higher is not better on golf score cards the numbers turned in by the friends, supporters and community partners of Community Access Unlimited (CAU) at the agency’s 18th Annual Golf Classic were well above par.  The May 10 event at Suburban Golf Club raised $40,000 for CAU programs. CAU provides supportive programs and services to people with disabilities and at-risk youth to help them live independent and fulfilled lives within the community. At the top of the leader board of support for the event was Innovative Benefit Planning, an employee benefit planning and financial services company located in Cinnaminson, New Jersey, which was the outing’s reception sponsor. “We do a good amount of work with nonprofits and we feel it is our obligation to support their causes, so it’s part of our mission to support Community Access Unlimited,” said Mark Sulpizio, the…

New Guidance on Summary of Benefits and Coverage Adds Safe Harbors

Posted On: May 18, 2012 | Categorized as: Company News, Employee Benefits, Health Care Reform

Starting on Sept. 23, 2012, health insurers and group health plans will be required to provide the summary of benefits and coverage (SBC) and the uniform glossary to consumers.  On May 11, the Department of Labor's Employee Benefits Security Administration, together with the Departments of Health and Human Services and the Treasury (the Departments), issued additional guidance in the form of 14 frequently asked questions (FAQs) for implementation of the SBC requirement of PPACA.  At the same time, the Department issued a corrected SBC template, a sample SBC and a guide for coverage examples calculator for diabetes cases. Among the issues the new set of FAQs address are the following: •    In addition to the previously provided safe harbors, SBCs may be provided electronically in connection with online enrollment or renewal and to participants and beneficiaries who request the SBC online, as long as individuals have the option to receive…

Mark and Nicole Attend the 8th Annual fi360 Conference in Chicago

Posted On: May 15, 2012 | Categorized as: Company News, Retirement Plans

Innovative’s Mark Sulpizio, MS Tax, AIF® and Nicole Offerman, AIF® joined approximately 600 advisors in Chicago for a three-day educational and networking event April 25th-27th.  A full range of nationally recognized speakers such as Harvard Business Review editorial director and author of The Myth of the Rational Market Justin Fox as well as Pulitzer Prize Winner Doris Kearns Goodwin, advocated for a broad acceptance of fiduciary ethics, regardless of regulatory imperative, and a commitment to act in the best interests of investors. Conference sessions focused on the application of the fiduciary standard for both individual investors and plan sponsors, the investment selection process, ongoing regulatory changes, and other topics related to fiduciary best practices. Attendees also had the opportunity to attend breakout sessions led by industry luminaries including Dave Gray, Vice President of Client Experience at Charles Schwab; Fred Reish, Partner at Drinker Biddle and Reath; and Ron Rhoades, JD,…

NAHU Hosts Webinar on Exchanges

Posted On: May 15, 2012 | Categorized as: Company News, Health Care Reform

On May 10, NAHU conducted a one-hour webinar on health insurance exchanges.  It was an exceptionally thorough overview of the topic, and I would encourage folks to listen/view it.  The link to the Professional Development page of NAHU's site (the webinar is the first item under the NAHU Webcasts heading): Just a couple of highlights (there were many): •    Premium subsidies and cost-sharing reduction subsidies will only be available via the Individual coverage exchanges (low-income people who buy coverage via a SHOP exchange are not eligible for subsidies) •    Low-income people who have access to "adequate" and "affordable" group coverage cannot leave the group plan and buy coverage via an exchange •    Employers will be required to help verify coverage in virtually any situation: o    Whether or not any employee purchases coverage through an exchange o    If an employer doesn't offer coverage at all o    After an employee enrolls…

Is CAM Right For You?

Posted On: May 10, 2012 | Categorized as: Company News, Workplace Wellness

A User’s Guide to Yoga Yoga is a mind-body practice with origins in ancient Indian philosophy. The various styles of yoga typically combine physical postures, breathing techniques and meditation or relaxation. The 2007 National Health Interview Survey found that yoga is one of the top 10 CAM practices used by U.S. adults. An estimated 6 percent of Americans use yoga for health purposes. Research suggests that regularly practicing yoga may: •    Improve mood and sense of well-being •    Counteract stress •    Reduce heart rate and blood pressure •    Increase lung capacity •    Improve muscle relaxation •    Help with anxiety, depression and insomnia •    Improve overall physical fitness, strength and flexibility To get started, find a teacher with whom you feel comfortable. Ask about the physical demands of the type of yoga in which you are interested. Check into the training and experience of the teacher you are considering. Try different…

Innovative Exhibits at the 26th Annual Tri-State HRMA Conference

Posted On: May 7, 2012 | Categorized as: Company News, Employee Benefits

Innovative was once again thrilled to be a part of the Annual Tri-State HRMA Conference held at the Westin Hotel in Mount Laurel last Thursday.  We enjoyed meeting all of the attendees while promoting our 2012 UBA Health Plan Benchmarking Survey.  For anyone that started the survey there, they were rewarded with a delicious cake pop!  Once the survey is completed online, the chance to win the New iPad is within reach! Please visit our Health Plan Benchmarking under the Resource tab on our website to participate.  Thanks to all who organized such a great event - see you next year!


Posted On: May 6, 2012 | Categorized as: Company News, Health Care Reform

The IRS has just issued three notices concerning key aspects of the 2010 Affordable Care Act (ACA).   Notice 2012-31 proposes three different methods by which sponsors of self-funded health plans could value the coverage they provide to plan participants and their dependents.   Notice 2012-32 and Notice 2012-33 then solicit comments on two related employer reporting requirements. This process for valuing and reporting employer health coverage goes to the heart of the ACA's individual and employer mandates.  It will also help target a tax credit designed to help low-income individuals pay premiums for health insurance purchased through a state-wide insurance exchange. "Minimum Essential Coverage" Versus "Essential Health Benefits" The "individual mandate" (the constitutionality of which is now under review by the U. S. Supreme Court) refers to the ACA requirement that most U.S. citizens either have "minimum essential coverage" or pay a penalty on their federal income tax return.  The emphasis…


Posted On: May 2, 2012 | Categorized as: Company News, Employee Benefits

On April 27, the IRS issued Revenue Procedure 2012-26, announcing the 2013 inflation-adjusted dollar limitations applicable to health savings accounts (HSAs) and qualifying high-deductible health plans (HDHPs). The maximum HSA contribution for an individual with self-only coverage under an HDHP will increase to $3,250 - up from $3,100 in 2012.  The maximum HSA contribution for an individual with family HDHP coverage will be $6,450 - up from $6,250 in 2012.  The "catch-up contribution" limit, for individuals who will attain age 55 by the end of the year, will remain at $1,000. To qualify as an HDHP, a plan must specify a minimum annual deductible amount, with that amount based on whether the coverage is self-only or family.  Those deductibles have also been adjusted for inflation.  For self-only coverage, the annual deductible must be no less than $1,250 - up from $1,200 in 2012.  For family coverage, the annual deductible must…

IRS Proposes Regulations on Fees to Fund Patient-Centered Outcomes Research

Posted On: April 24, 2012 | Categorized as: Company News, Health Care Reform

The IRS has issued proposed regulations regarding the fees imposed by health care reform on health insurers and on sponsors of self-insured health plans to support clinical effectiveness research by the new Patient-Centered Outcomes Research Institute (sometimes referred to as CER or PCOR fees). The fees apply only to policy or plan years ending after Oct. 1, 2012, and before Oct. 1, 2019 (i.e., for seven full plan years). For years ending before Oct. 1, 2013, the fee is $1 times the average number of covered lives under the policy or plan. For later years, the fee rate increases to $2, subject to adjustment based on changes in per capita National Health Expenditures as reported by the Treasury. Here are some highlights of the proposed regulations (which may be relied upon pending the issuance of final regulations): •    Affected Policies and Plans The fees paid by insurers generally apply to…

Revised Audit Guidelines

Posted On: April 18, 2012 | Categorized as: Company News, Employee Benefits, Health Care Reform

Recently, the Internal Revenue Service (IRS) published Revised Audit Guidelines for use by IRS auditors in examining group health plans for COBRA compliance.  The revised Guidelines incorporate changes to account for laws that have affected COBRA since the previous guidelines were developed, such as the Health Insurance Portability and Accountability Act (HIPAA) and the Family and Medical Leave Act (FMLA).  The Guidelines appear to herald a new COBRA compliance audit effort by the IRS. The Guidelines provide a general overview of the requirements, limitations, and exceptions of COBRA and the excise tax.  Notable highlights from the Guidelines include: •    Some insight into the IRS’s approach to COBRA enforcement.  By way of example, the Guidelines provide that when an employer contends that an employee was ineligible for COBRA rights because he was terminated for “gross misconduct,” an auditor may consider whether the employee was granted unemployment compensation benefits, whether the employee…

Healthy Supermarket Grab-and-Go Meals

Posted On: April 5, 2012 | Categorized as: Company News, Workplace Wellness

Long work hours and unfinished to-do lists often push our healthy eating habits to the back burner.  But being too busy doesn’t have to be your excuse for ordering a pizza or picking up dinner at the drive-thru window.  More and more, health-conscious consumers are relying on their supermarkets as a place to grab a freshly made, healthy meal.  Consumers’ increasing focus on eating fresh, healthy foods has presented a huge opportunity for supermarkets’ prepared foods programs.  Storeowners also recognize the economic challenges many shoppers are currently facing:  As gasoline and food prices climb, shoppers are looking for less expensive alternatives to restaurant takeout. Consider these healthy options from your supermarket grab-and-go: •    Rotisserie chicken that can be added to salads or shredded for burritos or chicken salad. •    Go to the seafood counter and have them steam your shrimp, clams or lobster right there.  You’ll also find ready-to-cook kebabs…

The DoL Fights Employers Failing to Remit Contributions

Posted On: March 22, 2012 | Categorized as: Company News, Retirement Plans

The  Labor Department’s Employee Benefits Security Administration (EBSA) has a long history of protecting the contributions employees make to their 401 (k), health care, and any other contributory plans by investigating employers who delay forwarding these contributions to the appropriate funding vehicle or who convert the contributions to other non-plan uses.   The Contributory Plans Criminal Project, initiated in 2010, is the first solely criminal national enforcement initiative.  The Labor Department’s focus on protecting employee contributions is multi-faceted: •    Conducting civil and criminal investigations into 401(k) misuse •    Issuing a regulation to shorten the time for transmission of contributions to the plan •    Launching an education campaign to inform retirement plan participants about their rights and ways to protect their pensions By the end of Fiscal Year 2011 there were 1,700 civil cases closed, 1,429 with corrected violations resulting in $58,773,213 in monetary results. Recently, one such lawsuit was filed against…

State Exchange Regulations Issued

Posted On: March 19, 2012 | Categorized as: Company News, Employee Benefits, Health Care Reform

On March 12, the federal Department of Health and Human Services (HHS) released a revised version of the federal rules regarding the "Establishment of Exchanges and Qualified Health Plans and Exchange Standards for Employers." Parts of the 644-page regulation have been issued as a final rule, meaning that they will have the full force of law within 60 days of the regulation's publication in the Federal Register on March 13. Other sections, including section 155.220(a)(3), which addressed the ability of a state to permit agents and brokers to assist qualified individuals in applying for exchange-based premium subsidies and cost-sharing reductions, have been issued as an interim final rule, meaning that they may be changed at a later date and are still open for public comment within 45 days. The newly released rule takes two of the proposed exchange rules that were issued during the summer of 2011 and combines them…

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