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IRS Allows 401K Match for Student Loan Repayments
The IRS recently issued a Private Letter Ruling (PLR) for an employer interested in offering a student loan repayment benefit through their 401(k) plan. While the ruling only applies to the plan and plan sponsor who requested it, the ruling will most likely expand interest in this type of program,...
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Interim Final Rule Updating the Penalties for Certain ERISA Violations
In the beginning of July, the Department of Labor (DOL) issued an interim final rule, effective August 1, 2016, adjusting the amounts of civil penalties as required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. In order to improve the effectiveness of civil monetary penalties, maintain their deterrent...
Read MoreRegion Matters When It Comes to HSA Funding, CDHP Adoption
We’ve already discussed Health Savings Account (HSA) activity at length, looking first at the correlation between generous HSA contributions and increased enrollment in consumer-driven health plans (CDHPs). Second, we looked at how HSAs have performed in recent years across different industries. Now, we’ll look closer at HSA activity across different regions of...
Read MoreTop 5 Questions about Medicare Secondary Payer Rules
Under federal regulations, Medicare is a secondary payer for many individuals who have an employer group health plan available to them, either as an employee or the dependent spouse or child of the employee. Generally the Medicare Secondary Payer rules prohibit employers with more than 20 employees from in any...
Read MorePotential Employer Penalties under the Patient Protection and Affordable Care Act
Employers that do not meet the requirements of the Patient Protection and Affordable Care Act (PPACA) need to be concerned about several potential penalties. Two significant penalties include the excise tax, which can be as much as $100 per affected individual per day, and the penalties that larger employers must...
Read MoreWraparound Excepted Benefits to Launch with Two Pilot Programs
Health plan sponsors would be permitted to offer wraparound coverage to employees purchasing individual health insurance in the private market, including the Marketplace, in limited circumstances, under a new Final Rule issued by the Department of Labor (DOL) and other federal agencies. The Final Rule, published March 18, 2015, sets forth two narrow pilot...
Read MoreIndustry Differences Among Health Savings Accounts
While recent survey data shows that, on average, employers are decreasing the amount they’re willing to contribute to employee Health Savings Accounts (HSAs), there are some industries that have not seen such trends. On average, employees saw a 10 percent decrease in their average single HSA employer contribution from the previous year,...
Read MoreSCOTUS and the Future of U.S. Health Care
The Patient Protection and Affordable Care Act (PPACA), commonly referred to as “Obamacare,” was signed into law with the intention of decreasing the number of uninsured Americans and reducing the overall costs of health care in the United States. In order to increase the number of U.S. citizens covered, a...
Read MoreCongress Taking (Small) Steps for Employee Wellness Programs
The Patient Protection and Affordable Care Act (PPACA) specifically encourages and promotes the expansion of wellness programs in both the individual and group markets. In the individual market, the secretaries of the departments of Health and Human Services (HHS), Treasury, and Labor are directed to establish a pilot program to...
Read MoreCost Sharing Limits Changing for 2016
In the Benefit and Payment Parameters for 2016 Final Rule issued in February 2015, federal agencies included a clarification that annual cost-sharing limitations for self-only coverage apply to all individuals, regardless of whether the individual is covered by a self-only plan or is covered by another kind of plan. Cost sharing refers...
Read MoreSupreme Court Hears Oral Argument in Subsidy Eligibility Battle
On March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA). At question in the case is whether or not the Internal Revenue Service (IRS) may issue regulations...
Read MoreCompliance Recap – March 2015
Coming off a busy February, regulatory agencies were noticeably quiet during the month of March. This allowed the Supreme Court to take the spotlight with oral arguments in the Patient Protection and Affordable Care Act (PPACA) related case, King v. Burwell. A clarifying FAQ was issued regarding cost-sharing limits for...
Read MorePPACA’s Impact on How CDHPs and HSAs Work Together
Employer health savings account (HSA) funding strategies have changed in recent years in response to the Patient Protection and Affordable Care Act (PPACA) and its impact on employer-sponsored health insurance plans. Employers are contributing less, on average, to HSAs and the increase in popularity of cost-saving consumer-driven health plans (CDHPs)...
Read MoreDefinition of “Spouse” Updated for FMLA
The Department of Labor has issued an updated definition for “spouse” under the Family and Medical Leave Act (FMLA) to make compliance with FMLA easier for both employers and employees. The new regulations will be effective on March 27, 2015, and will define “spouse” as a husband or wife, which...
Read MoreFinal Rule Issues Standards for Insurers and Marketplaces in 2016
Recently, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services issued a Final Rule with standards for insurers and Marketplaces in 2016, covering topics such as transparency in health insurance rate increases, formulary drug lists, drug mail order opt out provisions, determination of minimum...
Read MoreGrowing Pains: Why Adolescence Is About To Get That Much Harder
Employers that are growing up, and are in the awkward teenage years, are about to get a big surprise, and not the good kind. When a company first opens, they are excited when they first implement their benefit plans for their handful of employees. They offer one or two medical...
Read MoreIRS Provides Details on Reimbursing Premiums for Individual Health Coverage or Medicare Part B, Part D, or Medigap for Active Employees
On February 18, 2015, the Internal Revenue Service (IRS) issued Notice 2015-17. This Notice addresses employer payment or reimbursement of individual premiums in light of the requirements of the Patient Protection and Affordable Care Act (PPACA). For many years, employers were permitted to reimburse premiums paid for individual coverage on a...
Read MoreAgencies Provide Guidance on Single Benefit Products and Excepted Benefits
On February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits. Many provisions of PPACA do not apply to excepted health benefits. Supplemental excepted benefits are those that are provided under a separate...
Read MoreIRS Requests Input on the Cadillac Tax
Beginning in 2018, plans that provide coverage that exceeds a threshold will owe an excise tax that is frequently referred to as the “Cadillac tax.” The threshold generally will be $10,200 for single benefits and $27,500 for benefits provided to an employee, retiree, or member of a bargaining unit and...
Read MoreThink 2014 tax forms are bad? Here come the 1094 and 1095 for 2015!
Our recent blog reviewed the highlights of the new employer and insurer reporting requirements. The chart below is designed to help you sort out who should use which form, and when: For comprehensive information on coverage requirements, due dates, special circumstances, controlled groups and how to complete the forms—including sample situations—...
Read MoreHighlights of Employer and Insurer Reporting Requirements
The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption. Employers with 50 or more employees that do not offer affordable, minimum value coverage to their full-time employees also will...
Read MoreThe RFP vs. the Two Step Process — Choosing Group Health Insurance
Many employers look at employee benefits as a commodity, bidding out their plans annually — and who can blame them? Rising health care costs coupled with a challenging economic environment have forced many human resources decision-makers to focus heavily on cost. Organizations of all sizes struggle to find a balance...
Read MoreWhy Buy Group Health Insurance through a Broker?
Employers have a lot of choices when it comes to buying group health insurance, including going directly to a carrier (or one of its agents), buying online, or going through a broker. Direct-to-carrier paths make it more difficult to shop the market across product lines, and buying online can leave...
Read MoreIRS Provides Additional Details on Premium Payment Arrangements
The regulatory agencies have recently issued guidance that may affect employers that have been reimbursing premiums for individual health coverage or Medicare Part B, Part D or Medigap premiums for active employees. In addition, new rules were issued for single benefit supplemental plans, which may affect minimum essential coverage programs...
Read MoreHighlights of Employer and Insurer Reporting Requirements
The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption. Employers with 50 or more employees that do not offer affordable, minimum value coverage to their full-time employees also will...
Read MoreWill Health Insurance Soon Become Health Memberships?
With the passage of the Patient Protection and Affordable Care Act (PPACA), we saw a number of hospitals and provider groups being bought and merged with larger provider groups. This was done for two reasons. One, in part to make sure that they were able to establish more buying power,...
Read MoreIRS Releases Information and Forms for Satisfying the Individual Mandate and Claiming 2014 Premium Tax Credits
Although employers are not required to offer coverage during 2014, individuals are generally required to have health coverage during 2014 and must report on that coverage through their 2014 federal income tax return. In many cases, the employee will be able to simply state through a “yes/no” question on their...
Read MoreTop 5 Questions About The “Cadillac” Tax
The excise tax on high cost plans (also referred to as the Cadillac tax and the 4980I tax) is scheduled to take effect in 2018. To date, regulations have not been issued, so many of the details about how the tax will operate are unclear. (The regulatory agencies are responsible...
Read MoreProposed Changes to Summary of Benefits and Coverage (SBC)
The Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have issued proposed regulations that would update the summary of benefits and coverage (SBC) requirement, including the SBC template, instructions, example calculator, and uniform glossary. If adopted, the revised form would be used...
Read MoreInnovative Principal Speaks at Federal Reserve Bank
On Tuesday, January 13th Innovative’s Principal, Mark Sulpizio, was invited to participate at the Entrepreneurs’ Forum of Greater Philadelphia event at The Federal Reserve Bank of Philadelphia. Mark was featured as one of five panelists invited to speak at the EFGP Advisory Boards networking event. The group discussed important topics...
Read MoreInnovative Investment Fiduciaries Presents to HR Association
On Thursday, January 8th, Innovative’s Matthew Bernstein, Retirement Plan Consultant, and Mark Sulpizio, Managing Partner, were asked to speak at the Greater Princeton Human Resources Association’s (GPHRA) monthly meeting in Princeton, New Jersey. The presentation discussed the Pension Protection Act’s plan restatement requirement due April 30th 2016 which requires most...
Read MoreEmployees Just Don’t Understand…
Or are employers just not communicating effectively? In 2015, most organizations have employees that include Baby Boomers, Generation X, Generation Y, and Millennials. Each of these generations is different in the way they find information, digest information, and act on information. Now if you read the title to this post...
Read MoreConsider a Wellness Coach
Biometric testing has become the latest rage in wellness programs. If you’re unfamiliar with this, biometric testing (sometimes called biometric screening) involves measuring employees’ blood pressure, blood glucose, cholesterol, and similar measurements of employees’ health status. This testing can be a very helpful and important part of a corporate wellness...
Read MoreAre You Benchmarking Your Health Plan Correctly?
Many employers benchmark their health plans against other employers with the same carrier or using nationally available data. But the benchmarking best practice is to compare your plan with others based on plan type, region, employee size, and industry. Without this more granular data, you could be missing key data...
Read MoreDetermining Minimum Value and Affordability
The IRS has released final regulations that address how wellness incentives or penalties, contributions to a health reimbursement arrangement, and employer contributions to a Section 125 plan are applied to determine affordability. While these regulations were issued in connection with the individual shared responsibility requirement (also called the individual mandate),...
Read More2015 Cost-of-Living Adjustments
Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an “indexed” limit). The Internal Revenue Service and the Social Security Administration have released a number of indexed figures for 2015. Limits of particular interest to employers include the following. For health and...
Read MoreSupreme Court Agrees to Rule on Availability of Premium Tax Credits
Premium tax credits are only available to individuals who obtain health coverage through a Marketplace. A dispute has arisen as to whether the IRS has the ability to interpret PPACA to allow the subsidy to individuals who obtain coverage through any Marketplace, or whether the language of PPACA limits eligibility...
Read MoreUBA Releases 2014 Health Plan Survey Executive Summary
Recent survey data from the 2014 United Benefit Advisors Health Plan Survey, the nation’s largest health plan survey, shows that employers continue to shift a greater share of expenses to employees through out-of-pocket cost increases and reductions in family benefits, as well as delay many effects of the Patient Protection and...
Read MoreThe “Play or Pay” Package
The employer-shared responsibility (“play or pay”) requirements do not apply to small employers and have been delayed until 2016 for employers with 50-99 employees. This raises the question – what exactly is included in the play or pay requirement, which a small employer may be able to ignore and that...
Read MoreDecember Wellness Newsletter
QuickBites Weight-Loss Winners The National Weight Control Registry (NWCR) studies people who have lost at least 30 pounds and kept it off for a year or longer. More than 10,000 people have enrolled in the study. Once a year, members answer questions about their weight, diet, and exercise habits. The...
Read MoreCompliance Recap – November 2014
The month of November brought a new delay in reporting required from self-funded plans. It also brought several new notices and regulations that may affect sponsors of group health plans and an updated employer guide and health plan compliance checklist from the Department of Labor (DOL). Transitional Reinsurance Program Filing...
Read MoreWellness While Away
We all have barriers that get in the way of leading healthy lives. As we enter the holiday season, they seem to pile up more and more. My colleagues in the office will be the first to tell you, willpower is not one of my strengths when it comes to...
Read MoreTransitional Reinsurance Fee Filing Date Extended to December 5
The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for group health plans to complete their 2014 transitional reinsurance fee (TRF) submission. The announcement, which was released late on November 14, 2014, states that the filing is now due by 11:59 p.m. on Friday December 5, 2014....
Read MoreThe Benefit Guardian Makes an Appearance at Halloween
This past Halloween we were honored to see the first ever Innovative Benefit Guardian costume from one of our very own clients. David Liero, an employee from AFS, designed and assembled his one of a kind Benefit Guardian costume. David told us, “I first got the idea for the costume...
Read MoreCOMPLIANCE ALERT: Premium Reimbursement Arrangements
The Department of Labor (DOL) has just published a series of FAQs regarding premium reimbursement arrangements. Specifically, the FAQs address the following arrangements: An arrangement in which an employer offers an employee cash to reimburse the purchase of an individual market policy. Where an employer provides cash reimbursement for the...
Read MoreSubstance Abuse and Teens: Strategies for Prevention
Every year since 1975, the Monitoring the Future study has measured drug, alcohol and cigarette use among American youth. The study, sponsored by the National Institute on Drug Abuse (NIDA), surveys more than 40,000 eighth, tenth and twelfth graders. The 2013 results show a decrease in tobacco and alcohol use...
Read More2015 Cost-of-Living Adjustments
The IRS has issued the cost-of-living adjusted figures for qualified plans and for several fringe benefits for 2015. Of particular interest to many employers are: • An increase in the maximum employee contribution to a health flexible spending account (HFSA) to $2,550 • An increase in the 401(k) and 403(b)...
Read MoreRequirement to Obtain a Health Plan Identifier (HPID) Delayed
On Friday October 31, 2014 the Department of Health and Human Services (HHS) quietly updated its Health Plan Identifier information page to delay the requirement that insurance carriers and self-funded health plans obtain a health plan identifier (HPID). The delay is in effect until further notice. Plans that have already...
Read MoreHighlights of Wellness Program Requirements
The wellness program rules provide an exception to the general rule that employers may not take a person’s health status into account with respect to eligibility, benefits, or premiums under a group health plan. Wellness programs, therefore, are allowed if they are designed to help employees improve their health; if...
Read MoreFrequently Asked Questions about Grandfathered Plans
As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option. Innovative, in conjunction with our Partner firm United Benefit Advisors, has created an FAQ to address the questions employers have about grandfathering a group health...
Read MoreEssential Health Benefits, Minimum Essential Coverage, Minimum Value Coverage – What’s The Difference?
The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things. Here’s a closer look at these terms, and when they’re used. Essential Health Benefits Significantly affects individuals and small employers with a fully insured plan. Has a limited impact on self-funded and...
Read MoreUpdate: Same-Sex Marriages and Group Health Benefits
On October 6, 2014, the Supreme Court of the United States declined to review seven cases in which the lower appeals court had ruled that a state law or constitutional provision that prohibited same-sex marriage was unconstitutional. This declination means that the ruling of the appeals court is law, and...
Read MoreCompliance Alert! Deadline Approaching for Larger Self-Funded Health Plans To Obtain a Health Plan Identifier Number
To meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health...
Read MoreSkinny Plans and Minimum Value: Do these plans really pass the test?
There is a lot of buzz in the market right now as employers are implementing their plans for the upcoming year. Many employers are looking at ways to keep their costs for medical coverage low, but still meet the requirements of the Patient Protection and Affordable Care Act (PPACA). These...
Read MoreDON’T FORGET TO REGISTER! Philadelphia Lunch ‘N Learn this Friday
Are your employees getting their fair share? In 2012, the DOL issued new disclosure regulations requiring service providers to disclose the services provided and fees charged to retirement plans. Recently, the DOL has commented that the new regulations have not produced the desired effect, that plan sponsors review the disclosures...
Read MoreIRS Notice Addresses Handling of Changes in Measurement and Stability Periods
Large employers (for 2015, this generally means those with 100 or more full-time or full-time equivalent employees) may use either the monthly or look-back method to determine whether an employee on average works 30 or more hours per week, and for whom a penalty may be owed if adequate health...
Read MoreExcepted Benefits – “Limited Scope” Dental and Vision Plans and EAPs
On September 26, 2014, the U.S. Department of Health and Human Services (HHS), the Internal Revenue Service (IRS), and the Department of Labor (DOL) released final regulations that explain when dental and vision plans and employee assistance plans (EAPs) will be considered “excepted benefits.” Excepted benefits are health benefits that are...
Read MoreIRS Allows Additional Section 125 Change in Status Events
On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55 which allows employers to amend their Section 125 plans to recognize several new changes in status events. Open Enrollment in the Health Insurance Marketplace Prior to this new notice, an opportunity to enroll in the health insurance Marketplace (or...
Read MoreOur September Educational Events were a Tremendous Success!
Our Innovative team presented an educational seminar at DelFrisco’s Double Eagle Steakhouse in Philadelphia on September 19th, and also at Fleming’s Steakhouse in Marlton on September 25th. The events, which introduced innovative solutions for controlling the costs within your health plan while complying with PPACA, attracted C-level executives as well...
Read MoreIRS Issues Drafts of Instructions for Employer and Individual Responsibility Reporting Forms
The following is a summary of draft instructions. Some of this information may change when the final forms and instructions are released. In order for the Internal Revenue Service (IRS) to verify that individuals have the required minimum essential coverage, individuals who request premium tax credits are entitled to them,...
Read MoreInnovative Investment Fiduciaries Guest Presenters
On Tuesday, September 16th, Innovative’s Matthew Bernstein, Qualified Plan Consultant, and Mark Sulpizio, Managing Partner were asked to speak at MID Jersey Chamber of Commerce’s quarterly NPEC (Non-Profit Executive Council) meeting in Hamilton New Jersey. The presentation focused on the impact of the Department of Labor’s 408(b)(2) qualified plan fee...
Read MoreFrequently Asked Questions about the Transitional Reinsurance Fee (TRF)
The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016. The purpose of the fee is to provide funds to help stabilize premiums in the individual insurance market in view of uncertainty about how the Patient Protection and Affordable Care Act...
Read MoreEating For Healthy Cholesterol
Cholesterol The American Heart Association estimates that more than 120 million Americans have unhealthy cholesterol levels, putting them at greater risk for heart attack and stroke. Cholesterol is found in every cell in your body. When there’s too much cholesterol in your blood, you may develop fatty deposits in...
Read MoreGroup Health Plan Notices: What Do You Need To Include?
Employers that sponsor group health plans are required to give eligible employees a number of notices each year. Some notices must be given by a particular date, and some must be given as part of the enrollment packet. (This means that non-calendar year plans may need to provide Medicare Part...
Read MoreHighlights of the Summary of Benefits and Coverage Requirement
Plan administrators of group health plans, which includes all employers regardless of size or type of business with the exception of those that have been grandfathered, must provide a Summary of Benefits and Coverage (SBC) to eligible individuals. This requirement applies primarily to medical (PPO, HDHP, HMO, etc…) coverage. There...
Read MoreHow Can You Help Reduce Air Pollution?
Environmental Health Works Both Ways This month we look at how the environment affects health. Knowing about health problems related to the environment is an important part of making healthy lifestyle choices. This awareness starts at home. A safe, healthy environment in the home includes: Avoiding lead Testing for radon...
Read MoreIRS Issues Drafts of Individual Responsibility Reporting Forms
The following is a summary of draft forms. Some of this information may change when final forms, and the instructions, are released. In order for the IRS to verify that individuals and employers are meeting their shared responsibility obligations, and that individuals who request premium tax credits are entitled to...
Read MoreA September Lunch Event Is On The Calendar!
On February 10, 2014, the IRS issued final regulations on the employer requirements, often known as “Play or Pay.” For some employers Play or Pay is delayed until 2016, for others, compliance is still required in 2015. Make sure you know where you stand. Please join us on Friday September...
Read MoreCost of Living Adjustments for 2015
Many of the thresholds in PPACA have annual cost-of-living adjustments. The IRS has released the 2015 “affordability” thresholds. Affordability is measured differently for purposes of eligibility for the premium tax credit/subsidy (and any employer-shared responsibility penalty triggered by an employee receiving a premium subsidy) and the individual-shared responsibility penalty. For...
Read MoreCourts Issue Opposite Rulings in PPACA Subsidies Cases
On July 22, 2014, two Courts of Appeals issued decisions that address whether only people who live in states that have state-run Marketplaces (which are also called exchanges) are eligible to receive premium tax credits or subsidies under the Patient Protection and Affordable Care Act (PPACA). One court held that...
Read MoreAdditional Rules on Contraceptive Coverage
Following up on the Supreme Court’s decision in the Hobby Lobby case, the Departments of Labor, Health and Human Services, and Treasury have issued an FAQ that reminds employers that ERISA requires that plan participants be advised of a material reduction in benefits within 60 days after the reduction becomes effective....
Read MoreWill Your Private Plan Owe an MLR Rebate This Year?
MLR Rebate Considerations – Private Plans As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2013 experience by August 1, 2014. The rules...
Read MoreWill Your Government or Church Plan Owe an MLR Rebate This Year?
MLR Rebate Considerations – Government and Church Plans As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2013 experience by August 1, 2014....
Read MoreThe Federal Court of Appeals Says Subsidies for Obamacare are Illegal!
After an in-depth, careful reading of the Affordable Care Act, the Federal Appeals Court panel ruled 2-1 that government subsidies used to purchase health insurance on HealthCare.gov are illegal. The ruling stated that only exchanges that are run by an individual state, or the District of Columbia, are permitted to...
Read MoreFourth Circuit Court Says Subsidies in the Federal Exchange Are Legal
We now have a decision from another Court of Appeals (this time it’s the Fourth Circuit) on the exact same subsidy issue as posted earlier today. This court has held that it is legal for individuals enrolled in federally-run exchanges to receive subsidies. If this decision ultimately prevails, employers would...
Read MoreWhy HSAs Linked to HDHPs are Making a Comeback
According to new information from United Benefit Advisors (UBA), health savings accounts (HSAs) are outpacing health reimbursement arrangements (HRAs) in both adoption and participation rates. And now that metal tier health plans [e.g., platinum, gold, silver, etc.] are allowed higher deductibles, employers are increasingly looking at HSA qualified plans for...
Read MoreFollow-Up to the Hobby Lobby Decision
The Supreme Court of the United States recently decided in a case generally referred to as the Hobby Lobby case that closely-held corporations whose owners have religious objections to providing coverage for contraceptives are not required to provide that coverage to satisfy PPACA requirements. We still do not know how...
Read MoreWhat Does July 31st Mean To You?
Form 5500 With the exception of government plans (including most public schools) and many church plans which are exempt, plans on a calendar year that must comply with ERISA must file Form 5500 by July 31st. This form is part of ERISA’s overall reporting and disclosure framework, which is intended...
Read MoreGet Active for Summer!
People who are physically active live longer and have a lower risk for chronic disease. Going outdoors for exercise is good for your mental and physical well-being. Recent studies have found that, compared with exercising indoors, exercising in natural environments made people feel revitalized and energetic. The CDC advises adults...
Read MoreHave You Registered for Our July 15th Lunch Event in Cherry Hill?
Are your employees getting their fair share? In 2012, the DOL issued new disclosure regulations requiring service providers to disclose the services provided and fees charged to retirement plans. Recently, the DOL has commented that the new regulations have not produced the desired effect, that plan sponsors review the disclosures...
Read MoreWhat Employers Need to Know about SCOTUS Hobby Lobby Ruling
On June 30, 2014 the U.S. Supreme Court issued a decision in a case generally referred to as the Hobby Lobby case. Hobby Lobby is a family-owned for-profit corporation. The family that owns Hobby Lobby strongly believes that it would violate their deeply held religious values and obligations to provide...
Read MoreInnovative Receives Rave Reviews Once Again!
Last Friday at Sullivan’s Steak House in King of Prussia, our Innovative team revealed the three greatest concerns of our market regarding PPACA at an educational seminar lunch event. In speaking with clients and other employers in the area, it became clear that guidance is needed not only on compliance,...
Read MoreHow Does the New Orientation Period Affect the 90-Day Waiting Period?
The DOL recently (June 25, 2014) issued additional regulations regarding an Orientation Period for Employers. This Orientation Period is meant to provide both employer and employees alike the opportunity to evaluate whether the employment situation is satisfactory for each party. This period can occur prior to the start of the maximum...
Read MoreThe New Jersey Athletic Conference Board Invites Innovative As Their First Guest Speaker!
On Wednesday June 18th, Innovative’s Ryan Kastner, Employee Benefits Consultant, and Scott Agostini, Managing Director, were invited to speak at the NJAC (New Jersey Athletic Conference) semi-annual Board of Athletic Directors meeting in Atlantic City, where they educated the attendees on the possible effects of Health Care Reform to their...
Read MoreWhat Are The Final Regulations For PPACA’s Mandatory Reporting?
On September 5, 2013, the IRS issued proposed rules implementing the information reporting requirements under Code Sections 6056 and 6055. These proposed rules reflected a potential massive and duplicative amount of paperwork required by employers to comply with the reporting requirements of PPACA. On March 10, 2014, the IRS issued...
Read MoreNew Model COBRA Notices Should Be Used By Employers
The Department of Labor has published new model COBRA notices that reflect that coverage is available in the public health insurance exchanges and include information on special enrollment rights. Key points: • Employers should utilize the revised model notices. • Employers should be proactive in communicating with employees about “Marketplace”...
Read MoreSummer Skin Care Myths and Facts
Your skin is one hard-working organ. (Yes, it is considered an organ. In fact, it’s the body’s largest!) Skin acts as a protective barrier between your internal organs and the outside world. It’s a busy communications hub, constantly updating info on touch and temperature, and passing that info along to...
Read MoreHighlights of the Patient Centered Outcomes (PCORI) Comparative Effectiveness Fee
Updated June 2014 The Patient-Centered Outcomes Research Institute (PCORI) fee applies from 2012 to 2019. The fee is due based on plan/policy years ending on or after October 1, 2012, and before October 1, 2019. The fee is due by July 31 of the year following the calendar year in...
Read MoreDon’t Miss Our Next Seminar Lunch Event in King of Prussia!
PPACA Strategies- Innovative Solutions to Control Your Bottom Line With the passing of the Patient Protection and Affordable Care Act, CEO’s and CFO’s have never paid more attention to employee benefits than they are now. Please take advantage of the opportunity to be the most informed person in the room!...
Read MoreDo You Have The Correct Form To File Your PCORI Fees?
The Patient-Centered Outcomes Research Institute (PCORI) fee is imposed on insurers and plan sponsors of self-insured group health plans, with plan years ending after September 30, 2012 and before October 1, 2019. Sponsors of calendar year plans are required to pay the annual fee by July 31 of each year...
Read MoreAre The Fees In Your Retirement Plan Reasonable?
Are your employees getting their fair share? In 2012, the DOL issued new disclosure regulations requiring service providers to disclose the services provided and fees charged to retirement plans. Recently, the DOL has commented that the new regulations have not produced the desired effect, that plan sponsors review the disclosures...
Read MoreSearching For Answers? Find Out How Your Company Compares
Don’t Miss Your Chance To Participate In The Largest Health Plan Benchmarking Survey In The Country! End your search for answers by participating in the 2014 UBA Health Plan Benchmarking Survey…and you will automatically be entered in a raffle to win the new iPad Air!!! Your survey needs to be...
Read MoreCOMPLIANCE ALERT! Self-Funded Health Plans Must Obtain a Health Plan Identifier Number
To meet federal requirements large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health...
Read MoreHow Does COBRA Affect Marketplace Enrollment?
The Obama Administration announced last week that workers who are eligible to continue health insurance coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act), will now have the option of purchasing a plan through the Health Insurance Marketplace without having to wait until open enrollment. In many cases, workers will be...
Read MoreJoin Us For Our Lunch ‘N Learn May 16th: Managing Benefit Costs In The Health Care Reform Era
On February 10, 2014, the IRS issued final regulations on the employer-shared responsibility requirements, often known as “Play or Pay.” For some employers Play or Pay is delayed until 2016, for others, compliance is still required in 2015. Where do you stand? Please join us for a sizzling lunch where...
Read MoreInnovative Exhibits at the 28th Annual Tri-State HRMA Conference!
It was a “hole-in-one” day at the Westin in Mount Laurel on May 1st where about 250 attendees, and numerous exhibitors, came together for a day of education, networking and fun! Innovative Consultants Ryan Kastner, Dan Foley and Matt Bernstein, along with our Managing Director Scott Agostini, challenged attendees to...
Read MoreUnderstanding Arthritis
Understanding Arthritis More than one in five adult Americans has some form of arthritis. Arthritis causes pain, stiffness and limited movement in affected joints. There are at least 100 different types of arthritis. The two most common forms are osteoarthritis and rheumatoid arthritis. Exercise is a valuable tool for managing...
Read MoreCongratulations to Maria Black!
Time flies when you’re having fun! Maria Black is celebrating 13 years with Innovative Benefit Planning this month! As a Senior Account Manager, Maria works diligently with her clients on designing and administering their employee benefit packages. Maria’s clients love and appreciate her, as evidenced by the frequent “Wows!” that...
Read MoreInnovative Consultant, Ryan Kastner, Advises PEBA Attendees on Managing Benefit Costs
The 32nd Annual PEBA Forum took place last Thursday April 24th at the Hilton on City Line Avenue in Philadelphia. Innovative was proud to be an Exhibitor at this event and arrived ready to encourage attendees to take a chance at our mini golf game in order to win a...
Read MoreOur Innovative Team Continues To Grow With Scott Agostini As Managing Director!
We are very excited to announce the addition of Scott Agostini to Innovative Benefit Planning. As Managing Director, Scott will provide oversight on the day-to-day business operations. In addition, Agostini will use his many years of Human Resources management experience to grow Innovative’s HR consulting practice. Most recently, Agostini was...
Read MoreCost-Of-Living Adjustments for Health Savings Accounts (HSAs)
The IRS has issued the 2015 cost-of-living and coverage adjustments for HSAs. All limits have increased for 2015 as follows: Annual contribution limitation: Individual $3,350 (up from $3,300) Family $6,650 (up from $6,550) Annual Maximum Out-Of-Pocket Limits for HDHP*: Individual $6,450 (up from $6,350) Family $12,900 (up from $12,700) Annual...
Read MoreInnovative’s Mark Sulpizio Is Quoted In Employee Benefit Advisors
In the last few years, executive level employees have made a shift from working for larger companies, to running smaller companies. However, the benefits typically available at smaller companies can’t compare with those of their larger counterparts. So what is an employer to do in order to attract and retain...
Read MoreProposed Regulation: Health Plans Participating in the Exchange Must Provide a 90-Day Grace Period for Subsidized Coverage
For those individuals that purchase a subsidized health insurance plan through the Exchange, and have previously paid at least one full month’s premium during the benefit year, the insurance plan must provide for a 90-day grace period for premium payment before canceling for non-payment. Within this 90-day period, claims for...
Read MoreJoin Us At The 32nd Annual PEBA Forum On April 24th!
Innovative is looking forward to being an exhibitor at the 32nd Annual PEBA (PennJerDel Employee Benefits & Compensation Association) Forum this month, on Thursday April 24, 2014. The event will take place at the Hilton on City Line Avenue and is expecting an attendance of more than 300 compensation, benefit...
Read MoreHow Fit Are You?
Fat or Fit? Being healthy and fit is not just about being thin. Managing health is important for everyone, no matter what their size or shape. Not smoking, eating a healthy diet and managing stress are all vital to good health. Regular physical activity greatly reduces health risks too, even...
Read MoreJoin Us May 9th For Our Princeton Lunch ‘N Learn: Are The Fees In Your Retirement Plan Reasonable?
_ Are your employees getting their fair share? _ In 2012, the DOL issued new disclosure regulations requiring service providers to disclose the services provided and fees charged to retirement plans. Recently, the DOL has commented that the new regulations have not produced the desired effect, that plan sponsors review...
Read MoreRegulation Update: House Votes Full-Time As 40 Hours!
In a House vote of 248 to 179 last Thursday, the definition of full-time employee under The Patient Protection and Affordable Care Act (PPACA) was changed from 30 hours per week back to 40 hours per week. The bill was sponsored by Rep Todd C. Young, a Republican from Indiana. ...
Read MoreLook Who’s In The News!
Terriann Procida, one of Innovative’s Founding Partners, is once again recognized by the local community for her charitable contributions. Her work as Chairperson for the Samaritan Healthcare & Hospice Annual Gala for three years was recognized at the 2014 Gala by awarding her the Samaritan Circle of Excellence Award. In...
Read MoreSearching For Answers? Find Out How Your Company Compares
Don’t Miss Your Chance To Participate In The Largest Health Plan Benchmarking Survey In The Country! End your search for answers by participating in the 2014 UBA Health Plan Benchmarking Survey…and you will automatically be entered in a raffle to win the new iPad Air!!! Your survey needs to be...
Read MoreInnovative Welcomes Two New Team Members!
We are happy to announce the addition of two new members to the Innovative team: Molly Greer and Jennifer Fitzwater! Molly Greer is a return employee to Innovative after a 13 year respite. Molly’s previous experience in eligibility and claims has allowed a seamless transition back to Innovative. Molly is...
Read MoreMarketplace Enrollment Deadline Is Delayed For Some
The March 31, 2014 deadline for enrolling in the Marketplace is less than a week away, but for those who have at least started the enrollment process by that deadline, there will not be a penalty for an incomplete application. According to the U.S. Department of Health and Human Services,...
Read MoreOrganics is a growing industry in the United States
Organics is a growing industry in the United States. This is especially apparent in the produce aisle. Today, nearly all supermarkets offer a variety of organically grown fruits and vegetables. Sales of organic produce in 2013 increased by 12% over 2012 sales. In fact, 35¢ of every dollar spent on...
Read MoreIRS Releases Final Reporting Regulations
In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be required to provide reporting on the health coverage they offer. The reporting requirements...
Read MoreOption for Some to Renew Policies That Do Not Fully Meet PPACA Standards
On March 5, 2014, the Department of Health and Human Services (HHS) released a Bulletin that allows state insurance departments to permit the renewal through October 1, 2016, of individual and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act...
Read MoreThe Deadline Is Just A Few Weeks Away…
The Individual Mandate went into effect January 1, 2014. Compliance for this mandate requires that non-exempt U.S. citizens and legal residents must purchase and maintain “minimum essential coverage” which includes: • Individual market plans offered within a state, whether through or outside the Exchange • Eligible employer-sponsored plans • ...
Read MoreIt Was A Busy Month At Innovative With Two Outstanding Lunch Events and a Gala!
We did not let the snow get in our way in February! The month started off with _ Mark Sulpizio, Innovative Investment Fiduciaries, LLC Principal _, guiding attendees through the Retirement Fee Disclosure Regulations that went into effect in 2012 at a fantastic Seminar Lunch Event at McCormick & Schmick’s...
Read MoreDon’t Miss Your Chance To Participate In The Largest Health Plan Benchmarking Survey In The Country!
End your search for answers by participating in the 2014 UBA Health Plan Benchmarking Survey…and you will automatically be entered in a raffle to win the new iPad Air!!! With close to 11,000 employers participating in 2013, Innovative Benefit Planning, in conjunction with United Benefit Advisors (UBA), annually conducts the...
Read MoreFinal Regulations Issued on Eligibility Waiting Periods
On February 20, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) released final regulations on the eligibility waiting period requirements. The Patient Protection and Affordable Care Act (PPACA) provides that plans may not require an employee who is...
Read MoreFinal Regulations on Play or Pay: Non-Calendar Year Plans and Next Steps for Employers
Non-Calendar Year Plans Large employers with non-calendar year plans do not have to provide coverage until the start of the 2015 plan year, but the plan year effective date applies only if they meet a number of requirements. The most significant of these are: The employer had a group health...
Read MoreFinal Regulations on Play or Pay: Large Employer Responsibilities and Potential Penalties
If an employer is large enough for the play or pay requirements to apply (100 or more full-time or full-time equivalent employees for 2015 and 50 or more full-time or full-time equivalent employees for 2016 and beyond), two separate requirements, and potential penalties, apply. Full-time continues to mean 30 or...
Read MoreFinal Regulations on Play or Pay: Delay for Some Employers, and Who Is “Large”?
On February 10, 2014, the IRS issued final regulations on the employer-shared responsibility requirements, often known as “play or pay.” This is the requirement that large employers offer adequate coverage to their full-time employees or pay penalties. The final regulations follow the proposed regulations (which were issued in January 2013)...
Read MoreCompliance Alert! Employer Mandate Delayed For Some Employers
The Obama administration announced Monday February 10, 2014 yet another delay in the Employer Mandate portion of PPACA. The first delay pushed the requirement back to 2015 for all “large” employers, meaning those with over 50 employees. This new delay states that companies with 50-99 employees will not have to...
Read MoreWhat Is The DASH Diet?
The DASH diet is a healthy eating plan based on the research studies: Dietary Approaches to Stop Hypertension. The diet has been proven in National Institutes of Health research to help lower your risk of heart disease by lowering blood pressure and lowering cholesterol. Blood pressure control with the DASH...
Read MoreCongratulations to Dan Foley and Ryan Kastner!
A key component of Innovative’s 2014 Strategic Plan is Focusing on improving Ourselves, Client situations and Innovative (FOCI). Dan Foley and Ryan Kastner embraced the initiative of self-improvement by completing the 13 modules of training classes and passing a rigorous examination to earn the designation of Certified Corporate Wellness Specialist®...
Read MoreThe 2014 UBA Health Plan Benchmarking Survey Is Open!
End your search for answers by participating in the 2014 UBA Health Plan Benchmarking Survey…and you will automatically be entered in a raffle to win the new iPad Air!!! With close to 11,000 employers participating in 2013, Innovative Benefit Planning, in conjunction with United Benefit Advisors (UBA), annually conducts the...
Read More2014 Federal Poverty Level Numbers Released by the HHS
The 2014 FPL guidelines have been released and are available here: Federal Register, Volume 79 Issue 14 (Wednesday, January 22, 2014). For employer purposes, they matter primary because eligibility for the premium subsidy is based on FPL. The FPL is up 1.5% over last year. The level for a household...
Read MoreWellness Program Clarifications: Tobacco and Outcome-Based Alternatives
Additional PPACA clarifications were released by the HHS and DOL on January 9, 2014 through an FAQ. Here are the updates you need to know concerning your Wellness Program: Wellness Programs The FAQ states that a plan that offers an annual opportunity to receive an incentive for non-use of tobacco...
Read MorePPACA Update: Mental Health And Substance Abuse
A recent FAQ was released by the DOL and HHS to clarify certain regulations within PPACA. Here is the update on mental health and substance abuse disorders: Mental Health and Substance Abuse Disorders Coverage for mental health and substance use disorder services are an EHB, so non-grandfathered individual and small...
Read MorePPACA Update: Expatriate Plans, Fixed Indemnity Policies (Individual Market) and Volunteer Firefighters
Recent clarifications became available from the HHS and DOL regarding several PPACA regulations. Below are the updates for Expatriate Plans, Fixed Indemnity Policies, and Volunteer Firefighters. Expatriate Plans Insured expatriate plans do not need to comply with most PPACA provisions. The FAQ clarifies that a plan is considered an insured...
Read MoreNew Update To Coverage Under “Preventive Care”
On January 9, 2014, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury (IRS) issued clarification on several outstanding issues within PPACA through an FAQ. Here is what is new for preventive care: Preventive Care The requirement that non-grandfathered plans...
Read MoreNew Clarifications On Out-of-Pocket Maximums Under PPACA
On January 9, 2014 the HHS and DOL issued a new FAQ that addressed issues outstanding under PPACA. Here is the update for out-of-pocket maximums: Out-of-Pocket Limits The FAQ clarifies that, for non-grandfathered plans, the out-of-pocket maximum: Must include deductibles, coinsurance and copayments for essential health benefits (EHBs). A plan...
Read MoreDo You Know When To Use A Wrap Around Plan Document Or Wrap Around SPD?
The Employee Retirement Income Security Act of 1974 (ERISA) regulates employee pension plans and welfare benefit plans, with the exception of government and church plans. It is required by ERISA that plan sponsors describe the terms and conditions of its welfare benefit plans on an official written plan document that...
Read MoreDo You Have Questions About Eligibility Waiting Periods? You Are Not Alone!
The 90-day maximum for eligibility waiting periods is effective as of the start of the 2014 plan year. As employers are beginning to implement this new requirement, many have questions. Together with United Benefit Advisors (UBA), we have created a PPACA Advisor that addresses a number of recurring questions about...
Read MoreTerriann Procida To Receive The “Samaritan Circle of Excellence Award”
We are so proud to announce that Innovative’s Co-Founder, Terriann Procida, will be receiving the “Samaritan Circle of Excellence Award” at this year’s Samaritan Healthcare & Hospice Annual Fundraising Gala in February. The award will be presented to Terriann for her outstanding leadership and dedicated volunteer service to promoting comfort,...
Read MoreW-2 Reporting in 2014: Do You Have To Report Your Health Plan Costs, Or Not?
Employers that issued 250 or more W-2s in 2012 will need to include the cost of health coverage provided to an employee during 2013 on the employee’s W-2. Unlike most PPACA requirements, the 250 W-2 threshold is based on each employer’s situation, not the entire controlled group. The rules have...
Read MoreWhat Are Excepted Benefits?
“Excepted benefits” are health benefits that are limited in some way, such as stand-alone dental, long-term care, hospital indemnity, and Medicare supplement policies. Excepted benefits do not need to meet all of the PPACA requirements and they are not considered “minimum essential” benefits. The agencies have proposed three changes to...
Read MoreWho Will Be Paying An Additional Medicare Tax?
The IRS issued final regulations on the additional 0.9 percent Medicare tax owed by high earners beginning in 2013. Employers must withhold this additional 0.9 percent from the employee’s pay only (there is no employer “match”) once the employee’s pay exceeds $200,000. If you would like a White Paper on...
Read MoreWhat are the Projected 2015 Figures ?
HHS and the IRS released anticipated 2015 figures, including: A transitional reinsurance fee (TRF) of $44 (down from $63 for 2014) Maximum out-of-pocket (OOP) expenses of $6,750 for single coverage and $13,500 for family coverage (up from $6,350 and 12,700 respectively for 2014) A deductible maximum in the small group...
Read More5 Easy Strategies for Coping with Stress
Stress is a fact of life. A little stress can make you feel energized. It may even help you get things done. But constant stress can take a toll on your health. The effect can be both physical and mental. Poorly managed stress is a factor in many chronic health...
Read MoreFrequently Asked Questions About The W-2 Reporting Requirement
Employers that issued 250 or more W-2s in the prior calendar year must include the value of “employer-sponsored group health coverage” on their employees’ W-2s. This means that an employer that issued 250 or more W-2s during 2012 must include the value of employer-sponsored coverage on the employee’s 2013 W-2...
Read MoreWho Is Eligible For The Small Business Tax Credit?
Beginning in 2014, the small business tax credit will only be available to small employers that offer coverage through the SHOP marketplace. Several counties in Washington and Wisconsin will not have SHOPs available in 2014, however. In Notice 2014-6, the IRS states that employers located in those counties will still...
Read MorePre-Existing Condition Insurance Plan Extended
HHS has announced that the Pre-Existing Condition Insurance Plan (PCIP) also has been extended through January 31, 2014. The PCIP will be replaced by marketplace coverage, but to accommodate PCIP enrollees who have not been able to obtain coverage through the marketplace, the PCIP is being extended for one month....
Read MoreHHS Announces Extensions to Enrollment and Premium Deadlines for Marketplace Coverage
The U.S. Department of Health and Human Services (HHS) recently released an Interim Final Rule that formally extends some of the marketplace (also known as the exchange) deadlines and encourages insurers to provide additional extensions if possible. Extensions Affecting the Federally-Facilitated Small Business Health Options Program (FF-SHOP) Marketplace The rule...
Read MoreNew Option for Individuals Who Have Lost Coverage to Purchase a Catastrophic Policy
Currently, catastrophic coverage only is available in the marketplace to people under age 30 and to those who do not need to meet the individual mandate either because the cost of coverage exceeds eight percent of household income or they qualify for a hardship exemption. Catastrophic plans generally will cover...
Read MoreIRS Issues Notice about Same-Sex Spouses under Section 125 Plans, Flexible Spending Accounts, and Health Savings Accounts
On Dec. 16, 2013, the Internal Revenue Service (IRS) issued Notice 2014-1 which provides some answers about covering same-sex spouses under Section 125 plans in light of the Windsor decision. In the Windsor decision, the U.S. Supreme Court ruled that the part of the Defense of Marriage Act (DOMA) that prohibited...
Read MoreDo You Understand the 2014 Requirements for Your Wellness Program?
The wellness program rules provide an exception to the general rule that employers may not take a person’s health status into account with respect to eligibility, benefits, or premiums under a group health plan. Wellness programs, therefore, are allowed if they are designed to help employees improve their health; if...
Read More7 Healthy Eating Strategies For The Holidays
Some of our most cherished traditions are centered on food, particularly at this time of year. Most dieters will tell you that December is a tough time to follow a weight-loss plan. There are sweet temptations everywhere you turn. Friends and families are getting together over festive meals. A fresh-baked...
Read MoreMaximum Deductible for 2015 – Affects Small Employers With Fully Insured Plans
HHS has announced that it expects that in 2015 the maximum deductible for insured small group plans will be $2,150 for employee-only coverage and $4,300 for family coverage (up from $2,000 and $4,000 respectively for 2014).* While there may be modifications when the final notice is released, the figures likely...
Read MoreChanges Affecting Small Insured Plans
Beginning in 2015, if an insurer agrees to use a composite rate, the rate could not be changed during the year, even if the composition of the group changes. Insurers are encouraged to follow this practice during 2014. This applies both inside and outside the SHOP marketplace. The HHS actuarial...
Read MoreTransitional Reinsurance Fee – Affects Large and Small Employers, Whether Fully Insured or Self-Funded
The Internal Revenue Service (IRS) and the Department of Health and Human Services (HHS) recently issued an update on the Transitional Reinsurance Fee (TRF) as follows: A Transitional Reinsurance Fee (TRF) will be assessed on both insured and self-funded plans for the 2014, 2015, and 2016 calendar years to help...
Read MoreOpen Enrollment for the Marketplaces – May Affect Large and Small Employers, Whether Fully Insured or Self-Funded
Open enrollment for the individual marketplaces for 2015 coverage will run from Nov. 15, 2014, through Jan. 15, 2015. Coverage would begin on Jan. 1, 2015, for individuals enrolling from Nov. 15 through Dec. 15, 2014, and on Feb. 1, 2015, for those enrolling from Dec. 16, 2014, through Jan....
Read MoreAdditional Medicare Withholding For High Earners
The Internal Revenue Service (IRS) published Final Regulations on the Additional Medicare Tax (AMT) on Nov. 29, 2013, and an updated and comprehensive FAQ on Dec. 2, 2013. There are few changes from the proposed requirements. In summary: -The requirement for additional withholding was effective Jan. 1, 2013. -The requirement applies to...
Read MoreMaximum Out-of-Pocket for 2015 – Affects Large and Small Employers, Whether Fully Insured or Self-Funded
HHS has announced that it expects that the maximum out-of-pocket limit for non-grandfathered plans in 2015 to be $6,750 for employee-only coverage and $13,500 for family coverage (up from $6,350 and $12,700 respectively for 2014). While it is possible that there will be modifications when the final notice is released,...
Read MoreMental Health Parity and Addiction Equity Act of 2008 – Key Clarifications Made By Final Regulations
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) seeks to ensure that medical plans, including group health plans, that provide mental health and substance use disorder benefits do so in a manner that generally is on par with the medical benefits offered under the plans. The MHPAEA...
Read MoreOur November Lunch Events Were A Huge Success!
Guests at our Fiduciary Best Practices lunch event that was held at DelFrisco’s Double Eagle Steakhouse in Philadelphia on November 14th learned more about the fee disclosure regulations that went into effect in 2011. Innovative’s own Mark Sulpizio discussed how to better understand the fee disclosures provided and address what...
Read MoreCongratulations To Dr. William F. Muhr Of South Jersey Radiology!
Innovative would like to offer heartfelt congratulations to Dr. William F. Muhr, CEO of South Jersey Radiology, on his recent recognition by the readers of South Jersey Biz magazine as one of the areas 25 most respected names in business. Readers were asked to nominate local executives who are ensuring...
Read MoreCongratulations To Bob Pekar Of Twin Oaks Community Services
Innovative would like to extend heartfelt congratulations to Bob Pekar, CEO of Twin Oaks Community Services on his recent recognition by the readers of South Jersey Biz Magazine as one of the areas 25 most respected names in business in 2013! Mr. Pekar is a licensed clinical social worker who...
Read MoreInsurers Given Permission to Renew Policies That Don’t Meet PPACA Requirements
Yesterday (Nov. 14, 2013) the White House announced that insurers will not be required to meet most of the provisions of the Patient Protection and Affordable Care Act (PPACA) if they renew individual or small group policies that were in effect on Oct. 1, 2013. The Department of Health and...
Read MoreRyan Kastner, Employee Benefits Consultant, Educates CTP Guests About PPACA
On October 24, 2013, Ryan Kastner was honored to speak to an audience of 45 about the Patient Protection and Affordable Care Act (PPACA) at a workshop conducted by Career Transition Partnership (CTP) at Temple Emanuel in Cherry Hill. Ryan walked attendees through a timeline of provisions within PPACA, focusing...
Read More2014 Cost-Of-Living Adjustments for Health Plans, Section 125 Plans and Social Security/Medicare
Many employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an “indexed” limit). The Internal Revenue Service and the Social Security Administration have released the indexed figures for 2014. Because inflation is relatively low and some amounts are adjusted only if the increase...
Read MoreIRS Announces Retirement Plan Limitations For 2014
On October 31, 2013 the Internal Revenue Service and the Social Security Administration announced cost-of- living adjustments affecting dollar limitations for pension plans and other retirement–related items for the tax year 2014. The following highlights a breakdown of limits that have changed, as well as those that remain unchanged: Limits...
Read MoreAre You Ready For Thanksgiving? Tips For A Healthier Feast This Year!
Feast without Fear at Thanksgiving The average American will consume 2,500 calories or more at Thanksgiving dinner. And that doesn’t include the nibbles and drinks beforehand or the second slice of pie before bed. Check out these practical strategies for preventing heartburn after the big meal. Don’t Nibble Before Dinner...
Read MoreUBA’s Private Exchange “Benefits Passport” Is Now Open!
Employers, are you looking for an affordable insurance option to help reduce your costs, increase efficiency, simplify administration and provide exceptional value to your employees in light of Health Care Reform? Your search is over. United Benefit Advisors (UBA), the nation’s leading independent employee benefits advisory organization, announced yesterday the...
Read MoreHealth FSA “Use-It-Or-Lose-It” Rule Modified
What some would consider a long overdue change to FSA plans came down from the US Department of Treasury yesterday. The FSA “use-it-or-lose-it” provision, which has required employees to spend pre-tax dollars set aside for certain medical expenses by the end of the year or forfeit those funds, was put...
Read MoreSelf-Funded Employers Get Some Relief: Pay Only 2014 Transitional Reinsurance Fee!
Some employers with self-funded health plans can breathe a sigh of relief this week. The Department of Health and Human Services has announced that certain self-funding employers will be exempt from paying the second and third year Transitional Reinsurance Program Fees imposed by the Affordable Care Act. The first year...
Read MoreHealth Plan Benchmarking Regional Findings: How Does Your Plan Compare?
The benefits landscape remains in a state of flux as the cost of health care continues to increase and recruitment and retention of quality employees becomes more competitive. Combined with the potential impact from Health Care Reform legislation, employers are increasingly challenged to find accurate information that will help them...
Read MoreIs Eligibility For The Marketplace A Section 125 Change In Status Event For Non-Calendar Year Plans?
With the October 1st opening of the Health Insurance Marketplace, some employers have inquired about where they stand if an employee would like to leave their plan. In particular, those employers with a non-calendar year Section 125 plan have asked for guidance on whether entering the Exchange is considered a...
Read MoreBoiling Down PPACA
We’ve had a lot of employers request a simple, at-a-glance way to see all the PPACA requirements that apply to their business. This is no easy task given group size, SHOP exchanges and self-funding variables! Let’s just look at a few provisions that are effective for the plan year beginning...
Read MoreInnovative Welcomes Matt Bernstein!
We are pleased to announce the addition of Matthew Bernstein to the Innovative team. Matt is a graduate of Western New England College in Springfield, Massachusetts. As a Qualified Plan Consultant, Matt will be identifying, developing and nurturing potential client relationships in the Greater Philadelphia area. Matt is a dynamic,...
Read MoreHow Does Your Health Plan Stack Up Against Your Competitors?
See how your health plan stacks up against your competitors! Results from the United Benefit Advisors (UBA) 2013 Health Plan Survey are in! Employers can now benchmark their health plan costs and design against the nation’s largest health plan benchmarking survey of nearly 11,000 respondents. to receive a Benchmarking report...
Read MoreNew Guidance on HRAs and Premium Reimbursement Arrangements
On Sept. 13, 2013, the IRS issued Notice 2013-54, which includes details on permissible health reimbursement arrangements (HRAs), provides some clarification on minimum essential, minimum value and affordable coverage, and addresses payment of individual premiums through an employer-provided plan. HRAs Most people had expected that standalone HRAs would have difficulty...
Read MoreWhat Is A “Common Law Employee?”
As part of PPACA, every employer needs to determine whether or not they are “large” which, according to Health Care Reform, means employing 50 or more full time or full-time equivalent employees. Who exactly does this include? Contractors? While there is no set definition of a “Common Law” employee, there...
Read MoreVending Machine: Friend or Foe?
It’s not that hard to keep fruits, vegetables and other healthy snacks on hand at home. But the workplace is another story. If you haven’t brought a snack from home, you’re likely to visit the vending machine. If you look carefully, you can often find healthy – or at least...
Read MoreGOVERNMENT SHUTDOWN – NOW WHAT?
The failure of the U. S. Senate and House of Representatives to agree on a new budget for the Fiscal Year (beginning October 1) is resulting in a furlough of more than 800,000 federal workers and government agencies temporarily closing or cutting back the operations of numerous federal facilities and...
Read MoreIRS Provides Process to Correct Over-Withholding of Same-Sex Spouse Benefits
On Sept. 23, 2013, the IRS issued Notice 2013-61. This notice provides a special process for employers to make refund claims or internal adjustments of FICA and federal income tax (FIT) that was withheld or paid in connection with same-sex spouse benefits. Employers that prefer to use the normal refund...
Read MoreHighlights of the SHOP Exchange
PPACA requires that a Small Business Health Options Program (SHOP) exchange/marketplace be established in each state for small employers. For 2014, all states will use 50 employees as the cut-off for small employer status.* Beginning in 2016, all states must use 100 employees as the cut-off. The SHOP exchanges/marketplaces will...
Read MoreDOL Announces Non-Enforcement of Marketplace/Exchange Notice
PPACA requires employers covered by the Fair Labor Standards Act to provide a notice about the upcoming health marketplaces (also called exchanges) to their employees. The notice is due Oct. 1, 2013. On Sept. 11, 2013 the Department of Labor (DOL) announced that it will not penalize employers that do...
Read MoreA Delay for Out-Of-Pocket Maximums
A few weeks ago several media outlets picked up a FAQ that the Department of Labor issued in February of this year. The FAQ may be accessed here: FAQs About Affordable Care Act Implementation Part XII Some of the reports have created confusion about the requirement, and the scope of...
Read MorePractice Positivity to Help Beat Stress
Being a positive thinker can affect your life more than you realize. Practicing positive thinking may make you a healthier person. Lower rates of heart disease and mental illness are linked to positive thinking. Positive psychology is a new branch of psychology that’s about 15 years old. Specialists in positive...
Read MoreIRS Releases Proposed PPACA Reporting Rules
On Sept. 5, 2013, the Internal Revenue Service (IRS) released the long-awaited rules that describe the reporting that plans, employers, and insurers will need to provide in support of the individual shared-responsibility and employer shared-responsibility requirements of the Patient Protection and Affordable Care Act (PPACA). The rules are proposed, so...
Read MoreHighlights of Exchange Notice Requirement
Most employers must give a notice about the upcoming health exchanges/marketplaces to all existing employees by Oct. 1, 2013. Employees hired after that date must receive the notice within 14 days following their start date. All employers who are subject to the Fair Labor Standards Act must give the notice....
Read MoreFrequently Asked Questions about the Exchange (Marketplace) Notice
This FAQ is based on Department of Labor (DOL) Technical Release 2013-02, which does not provide specific guidance on many issues. Consequently, some of the answers in this FAQ are based on agency guidance provided in similar situations. The answers in this FAQ assume the employer is completing the model...
Read MoreIRS Issues Rules on Same-Sex Marriages
On Aug. 29, 2013, the IRS issued Revenue Ruling 2013-17, which describes how the IRS will handle same-sex marriages for federal tax purposes in light of the U.S. Supreme Court decision that found a part of the Defense of Marriage Act (DOMA) unconstitutional. The ruling says: The IRS will consider...
Read MoreThe October 1st Deadline Is Just Around The Corner: Employers Must Provide Notices Regarding Availability of Exchange Coverage
A provision of the 2010 health care reform law requires employers to provide notices to all employees regarding the availability of health coverage options through the state-based exchanges created pursuant to that law. The DOL issued temporary guidance on May 8, 2013 (Technical Release 2013-02) and model notices for employers...
Read MoreEnsure Employee Health and Reap the Benefits
It sounds simple enough: improve workforce health, reduce health care costs. It’s a private matter, one’s health, but many employers invest in on-site exercise equipment, sports teams or any number of activities that not only promote camaraderie, but wellness as well. On the other side of the coin, many more...
Read MoreThe Real Story on Out-Of-Pocket Maximums
Last week several media outlets picked up a FAQ that the Department of Labor issued in February of this year. The FAQ may be accessed here: FAQs about Affordable Care Act Implementation Part XII Some of the reports have created confusion about the requirement, and the scope of what has...
Read MoreFrequently Asked Questions About Grandfathered Plans – Part Two
Those employers with grandfathered status need to decide if maintaining grandfathered status is their best option for the coming year. Here is a continuation of the questions asked most frequently, and answers, about grandfathering a group health plan. Q5: How are changes measured? A5: Changes are measured cumulatively since March...
Read MoreFrequently Asked Questions About Grandfathered Plans – Part One
As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option. Following are some frequently asked questions, and answers, about grandfathering a group health plan. Q1: May plans maintain grandfathered status after 2014? A1: Yes, they...
Read MoreSeafood, Your Healthy Heart Hero
Seafood and Your Healthy Heart Following a healthy diet is a proven way to reduce your risk of heart disease. Pairing healthy eating with a physically active lifestyle will lower that risk even more. Most of us know which types of food can contribute to heart disease. We try to...
Read MoreThe Individual Mandate: Noteworthy Numbers
For 2013: The tax filing threshold is $10,000 if filing single and $20,000 if married and filing jointly. Federal Poverty Level (FPL) in the 48 contiguous states is $11,490 for a single household and $45,960 for household of four. It is $14,350/29,440 in Alaska and $13,230/27,090 in Hawaii. The subsidy...
Read MoreIndividual Mandate: Who Is Exempt?
While most people must obtain coverage or pay penalties, individuals in these situations will not be penalized if they do not obtain coverage: They do not have access to affordable coverage (cost exceeds 8 percent of modified adjusted gross household income) Their household income is below the tax filing...
Read MoreIndividual Mandate: Who Is Eligible For Premium Subsidies?
To help lower-income people meet the requirement to have insurance, a premium subsidy will be available to a person who: Purchases coverage through a public marketplace/exchange; and Has a household modified adjusted gross income between 100 or 133 percent (depending on their state) and 400 percent of Federal Poverty Level...
Read MorePPACA And The Individual Shared Responsibility Requirement
Although the employer shared responsibility requirements have been delayed to 2015, the individual responsibility requirement (also known as the individual mandate) is still scheduled to take effect in 2014. Under the individual mandate, most people residing in the U.S. will be required to have minimum essential coverage, or they will...
Read MoreMLR REBATE CONSIDERATIONS – PRIVATE PLANS
As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2012 experience by Aug. 1, 2013. The rules for calculating and distributing these rebates...
Read MoreMLR REBATE CONSIDERATIONS – GOVERNMENT AND CHURCH PLANS
As was the case last year, insurers with medical loss ratios (MLRs) that were below the prescribed levels on their blocks of business must issue rebates to policyholders. Insurers must pay rebates owed on calendar year 2012 experience by Aug. 1, 2013. The rules for calculating and distributing these rebates...
Read MoreIRS Confirms Play or Pay Delay
On July 9, 2013 the Internal Revenue Service issued Notice 2013-45, which confirms that the employer shared responsibility penalties and reporting requirements will not apply until 2015. Last week the Department of the Treasury and the White House blogged that this announcement was coming. The IRS Notice states that employers...
Read MorePlay It Safe Outside!
BUGS BEWARE! Mosquitoes, ticks and people all share the great outdoors as their playground. The insects may be more than a nuisance to be swatted away. In the U.S., mosquitoes may transmit some rare but serious diseases including West Nile virus, St. Louis encephalitis, dengue and eastern equine encephalitis. Ticks...
Read MoreSpanish Version of Notice of Exchange is Now Available
The DOL has provided Spanish versions of the model notice regarding the exchange/health insurance marketplace. While employers are not specifically required to provide the Spanish version to Spanish-speaking employees, since the notice is supposed to be understandable by the average employee, providing the Spanish version where appropriate is advisable. There...
Read MorePlay or Pay Penalty Delayed To 2015
On July 2, 2013 the Department of the Treasury and the White House used their blogs to announce that the employer reporting requirements, and the employer shared responsibility/Play or Pay penalty, are being delayed until 2015. The Treasury said that it will provide a formal announcement and additional details next...
Read MorePPACA: Individual Grace Period
Effective Date for Individual Mandate Delayed For Some People On June 26, 2013 the IRS unexpectedly issued a notice that gives individuals who are eligible for coverage under an employer-sponsored health plan, but who have not elected coverage under that plan, until the start of the 2014 plan year to...
Read MoreU.S. Supreme Court Rules Legally-Married Same-Sex Spouses Entitled to Federal Recognition and Lifts California Ban on Same-Sex Marriage
The United States Supreme Court has issued two decisions that expand same-sex marriage rights. In the first, United States v. Windsor, No. 12-307 (June 26, 2013), the Court ruled unconstitutional a law denying federal recognition of legally-married same-sex couples. In the second, Hollingsworth, et al. v. Perry, No. 12-144 (June...
Read MoreThe 2013 UBA Health Plan Benchmarking Survey Has Closed And The Winner Of The iPad Is…
THE WINNER IS: The Philadelphia Zoo!!! We had an overwhelming response to our 2013 UBA Health Plan Benchmarking Survey and we are happy to announce that we have randomly picked the winner for the Apple 32 GB iPad! With over 18,000 plans participating, including more than 75 plans from our...
Read MoreHave You Made Any “Material Modifications” To Your Plan Since Your Last SBC Was Issued?
If a group health plan or health insurance issuer have made any material modification (during the plan year) in terms of the plan or coverage involved that’s not reflected in the most recent Summary of Benefits and Coverage (SBC), the plan or issuer must provide notice of the modification to...
Read MoreCOMPLIANCE ALERT!! Final “SHOP” Regulations Issued
On June 4, 2013, the Department of Health and Human Services (“HHS”), Centers for Medicare & Medicaid Services (“CMS”), issued final regulations implementing the provisions of the Affordable Care Act (“ACA”) related to the establishment and operation of the Small Business Health Options Program (“SHOP”). The final regulations delay by...
Read MorePCORI Fee Due Date
By July 31, 2013, most issuers of health insurance policies and plan sponsors of self-insured health plans must pay a fee of $1 per covered life as a result of new provisions in the Patient Protection and Affordable Care Act. The fee will partially fund the Patient-Centered Outcome Research Institute...
Read MorePPACA: Certificates of Creditable Coverage
Affects all plans, whether fully insured, self-funded or grandfathered, and regardless of employer size, as of Jan. 1, 2015. Because pre-existing condition limitations will not be permitted after the start of the 2014 plan year, certificates of creditable coverage would not need to be provided after Dec. 31, 2014. (This...
Read More8 Men’s Health Myths Exposed
Men get their health news from many sources: friends at the gym, their doctors, current publications and the Internet. A lot of the information is accurate. Some of the info mixes truth and rumor. Some of it is just plain wrong. Let’s take a look at eight popular myths about...
Read MoreAGENCIES ISSUE FINAL RULES ON WELLNESS PROGRAMS
On May 29, 2013 the Department of Health and Human Services, the Internal Revenue Service and the Department of Labor jointly issued a final rule that addresses how wellness programs must operate under PPACA beginning in 2014. In many respects the final rules carry forward the rules that have been...
Read MoreHealth Care Reform Lunch Events Scheduled for July – Register Now!
In the last few weeks, Innovative hosted two more Health Care Reform seminar lunch events in Weehawken and Marlton. Since the November election we have hosted ten of these events, and have been requested to present at several networking events. The feedback on our program is excellent and we appreciate...
Read MoreDo You Know What The Summary Of Benefits & Coverage Requirements Are Under Health Care Reform?
A Summary of Benefits & Coverage (SBC) is required starting the first day of the first plan year after September 23, 2012, or the first day of the first open enrollment period after this date. Health insurers and group health plans must provide the SBC and the Uniform Glossary to...
Read MoreCOMPLIANCE ALERT! Employers Must Provide Notices Regarding Availability of Exchange Coverage
A provision of the 2010 health care reform law requires employers to provide notices, by March 1, 2013, to all employees regarding the availability of health coverage options through the state-based exchanges created pursuant to that law. In January, the Department of Labor had announced delayed enforcement of the exchange...
Read MoreA Great Day at the Tri-State SHRM Expo!
As both an exhibitor and speaker at the May 13th event in Mount Laurel, we had a great time meeting and speaking with all of the attendees. Our custom-made fortune cookies were a big hit! Terriann spoke at a breakout session on the topic of Play or Pay within PPACA. ...
Read MoreWomen’s Health Myths
Do you go online to learn about your health? You’re not alone. A recent Pew survey showed 72% of Internet users looked for health info online. And women are more likely to do so than men. But you do need to be careful. Not all health sites are accurate. And...
Read MoreAN UPDATED SUMMARY OF BENEFITS AND COVERAGE FORM AND ANNUAL LIMITS WAIVERS
The agencies have released an updated Summary of Benefits and Coverage (SBC) template that plans will need to use for 2014. The updated template has very few changes from the version used for 2013. The primary change is that the 2014 SBC must state whether or not the plan provides...
Read MoreWellness Incentives and the Play or Pay Requirement
The Departments of Labor, Health and Human Services and the Treasury have issued several updates that affect employer-sponsored group health plans. Wellness Incentives, HRAs, Minimum Value and Affordability The IRS has released proposed regulations that address how wellness incentives or penalties are applied to premium affordability (for purposes of the...
Read MoreThe Department of Labor Begins Auditing Group Health Plans for PPACA, GINA and Wellness Program Compliance
Employers that have had their group health plans audited by the Employee Benefits Security Administration (EBSA, the arm of the U.S. Department of Labor that enforces Title I of ERISA) are aware of the broad nature of the document requests and compliance reviews carried out under these audits. The EBSA...
Read MoreInnovative Welcomes Stayce Godfrey-Smith To Our Team!
Stayce joined the Innovative team mid-April as a Benefits & Eligibility Specialist. Her extensive background in health and welfare administration will prove invaluable in her new role, as will her experience in client service and management. As an integral addition to our Account Management team, we are confident that Stayce...
Read MoreCOMPLIANCE ALERT! Important Transition Relief for Non-Calendar Year Plans
The January 1, 2014 effective date of the Pay-or-Play requirements under health care reform presents special issues for employers with non-calendar year plans. Prior to the release of the proposed regulations under the shared responsibility rules, employers with non-calendar year plans would either need to comply with the Pay-or-Play requirements...
Read MoreInnovative Is Proud To Support the Seventh Annual American Heart Association Go Red for Women Luncheon!
On Thursday April 11, 2013 Innovative attended the Go Red for Women Lunch Event at Lucien’s Manor in Berlin, New Jersey. Today, heart disease is STILL the #1 killer of women, causing 1 in 3 deaths each year. But it can be prevented. Knowledge of the risk factors for heart...
Read MoreEssential Health Benefits, Minimum Essential Coverage, Minimum Value Coverage – What’s The Difference?
The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things. Here’s a closer look at these terms, and when they’re used. Essential Health Benefits Significantly affects individuals and small employers with a fully insured plan. Has a limited impact on self-funded and...
Read MoreManaging Seasonal Allergies
The Worst Offenders Seasonal allergy is caused by tree pollen in the early spring. During the late spring and early summer, the irritating pollen is usually from grasses. Weeds are the typical pollen source in late summer and into the fall. Tree Pollen In springtime, trees release huge amounts of...
Read MoreEmployers, Do You Know What You Need To Do Before January 2014 To Comply With PPACA?
The provisions associated with health care reform pose many questions for employers, most importantly, what do I need to do and when? Here is a checklist of items to cross off your list before January 2014: Calculate and pay the Patient Centered Outcome Fee if the plan is self-funded (insurers...
Read MoreREGISTER NOW!! Health Care Reform Lunch ‘N Learn Events in Weehawken and Marlton
Since the November Presidential election, Innovative has hosted eight Lunch N’ Learn events in New Jersey, Pennsylvania and New York, and we have just added two more! We will be having our first Weehawken event at The Chart House Restaurant this month on April 24th, and we will be back...
Read MorePPACA Update: External Claims Appeals Requirement
Applies to all nongrandfathered plans, whether fully insured or self-funded, and to all sizes of employers. PPACA requires all nongrandfathered plans to follow detailed processes for claims appeals, including a process for external review that includes 16 consumer protections required under the NAIC model act. Due to practical difficulties meeting...
Read MoreTerriann to Speak about Health Care Reform at Tri-State HRMA’s 27th Annual Conference
Since the election in November, Terriann Procida has been educating employers about Health Care Reform, specifically the new Play or Pay regulation. Do you know what you need to do to begin budgeting for the 2013-2014 PPACA Provisions? Do you understand how potential penalties associated with Play or Pay may...
Read MorePPACA Update: Certificates of Creditable Coverage
Affects all plans, whether fully insured, self-funded or grandfathered, and regardless of employer size, as of Jan. 1, 2015. Because pre-existing condition limitations will not be permitted after the start of the 2014 plan year, certificates of creditable coverage would not need to be provided after Dec. 31, 2014. (This...
Read MorePPACA Update: Eligibility Waiting Periods
Affects all plans, whether fully insured, self-funded or grandfathered. Applies to all sizes of employers, as of the start of the 2014 plan year. The agencies have issued proposed regulations that state that an eligibility waiting period cannot be more than 90 days. This literally is 90 calendar days —...
Read MorePPACA Employer Fees: Patient-Centered Outcomes Research Institute (PCORI) and Transitional Reinsurance (TRF)
The IRS and the Department of Health and Human Services have issued final regulations that provide details on two new, temporary fees that will be due as part of the Patient Protection and Affordable Care Act (PPACA). These fees will be calculated and paid directly by self-funded plans. The fees...
Read MorePlay or Pay: Non-Calendar Year Transition Rules for Measuring in 2013
A non-calendar year plan that had coverage in place on Dec. 27, 2012: Will not owe the “inadequate coverage penalty” on any employee who was eligible for coverage on Dec. 27, 2012 (and on employees hired after that date, if they would have been eligible under the rules in effect...
Read MoreInnovative Attends Saint Joseph’s University Career Fair
Innovative Benefit Planning is looking for highly motivated individuals to join our growing team. As a part of our recruiting initiative, we participated in the spring 2013 Career Fair at Saint Joseph’s University where we were among 161 companies searching for the best and the brightest. The turnout was impressive,...
Read MoreFinal Regulations Issued on Market Reforms-Fair Health Insurance Premiums for Fully Insured Health Care Plans
Impacts all non-grandfathered fully insured small group plans (both in and outside the exchange) beginning with the 2014 plan year: The changes in the rules that apply to fully insured small groups, whether the coverage is provided inside or outside the exchange, are significant. From an employer standpoint, the most...
Read MoreFinal Regulations Issued on Market Reforms-Guaranteed Access for Fully Insured Health Care Plans
Impacts all nongrandfathered fully insured plans, whether inside or outside the exchange, beginning with the 2014 plan year: Guaranteed issue and renewal will apply to all insured plans regardless of size. Participation and employer contribution requirements will not be permitted under the guaranteed availability rules, although insurers may impose participation...
Read MoreFinal Regulations Issued on Essential Benefits and Actuarial Value for Fully Insured Health Care Plans
Impacts non-grandfathered small-group plans (both in and outside the exchange) beginning with the 2014 plan year: Beginning with the 2014 plan year all nongrandfathered plans in the small group market – whether inside or outside the exchange – will need to provide the “essential health benefits package” (EHB package). The...
Read MoreIt’s Time to Get Your Yoga On!
Yoga and Back Pain Prevention Lack of exercise is a risk factor for developing back pain. Exercise not only strengthens the muscles of the back, neck and shoulders, but it also relaxes the back, reduces pain and increases flexibility. It is recommended to do 15 to 30 minutes of back...
Read MoreFAQ Released: Final Regulations Issued on Minimum Value for Self-Funded Health Care Plans
Impacts all self-funded plans as of the start of the 2014 plan year Self-funded plans (regardless of size) will not be required to provide the ten “essential health benefits” or coverage at a “metal level” as some plans will be required to do. (The essential health benefits are coverage within...
Read MoreFAQ Released: Final Regulations Issued on Minimum Value for Fully Insured Health Care Plans
Impacts large fully insured plans with 50 or more employees: Large group insured plans are not required to provide the ten “essential health benefits” or coverage at a “metal level” as small plans will be required to do. (The essential health benefits are coverage within these categories – ambulatory/outpatient, emergency,...
Read MoreCOMPLIANCE ALERT: Labor Department Releases New FMLA Model Forms and Notice Poster
The U.S. Department of Labor has released revised model Family and Medical Leave Act (“FMLA”) forms to administer federal FMLA leave and a notice poster. The updated forms should be used by employers immediately, although they include no substantive revisions despite recent rulemaking on the FMLA military caregiver leave provisions...
Read MoreSelf-Funded Health Care Plans FAQ Released: Final Regulations Issued on Out-of-Pocket Limits
Impacts all non-grandfathered self-funded plans beginning with the 2014 plan year The FAQ also talks about the out-of-pocket maximum requirements. Beginning with the 2014 plan year, plans may not have an out-of-pocket maximum that is larger than the allowed out-of-pocket limit for high-deductible health plans (HDHP) issued in connection with...
Read MoreFully Insured Health Care Plans FAQ Released: Final Regulations Issued on Out-of-Pocket Limits
Impacts all nongrandfathered fully insured plans beginning with the 2014 plan year: The FAQ also talks about the out-of-pocket maximum requirements. Beginning with the 2014 plan year, plans may not have an out-of-pocket maximum that is larger than the allowed out-of-pocket limit for high-deductible health plans (HDHP) issued in connection...
Read MoreSelf-Funded Health Care Plans FAQ Released: Final Regulations Issued on Preventive Care
Impacts all non-grandfathered, self-funded plans now: The agencies have received many questions about the requirement to provide first-dollar preventive care. They have now issued a FAQ that clarifies that: While plans generally do not need to provide out-of-network preventive care if there are no in-network providers able to provide the...
Read MoreFully Insured Health Care Plans FAQ Released: Final Regulations Issued on Preventive Care
Impacts all non-grandfathered fully insured plans now: The agencies have received many questions about the requirement to provide first-dollar preventive care. They have now issued a FAQ that clarifies that: While plans generally do not need to provide out-of-network preventive care if there are no in-network providers able to provide...
Read MoreFAQ Released: Final Regulations Issued on Whistleblowing for Self-Funded Health Care Plans
Impacts all self-funded plans beginning April 2013 PPACA prohibits employers (including insurers) from retaliating against an employee for reporting possible violations of PPACA to his employer or to the government, providing testimony about the possible violation or refusing to violate the law. It also prohibits retaliating or taking an unfavorable...
Read MoreFAQ Released: Final Regulations Issued on Whistleblowing for Fully Insured Health Care Plans
Impacts all fully insured plans beginning April 2013 PPACA prohibits employers (including insurers) from retaliating against an employee for reporting possible violations of PPACA to his employer or to the government, providing testimony about the possible violation or refusing to violate the law. It also prohibits retaliating or taking an...
Read MoreThe “Set Sail: Samaritan Celebration of Life Gala” Was A Great Success Once Again!
The Samaritan Healthcare & Hospice Annual Gala took place Saturday February 23rd with a “Cruise” theme, complete with music, dancing, gambling, auction, and of course, great food! Kathy Orr, CBS 3 Eyewitness News Emmy-Award-Winning Meteorologist brought great energy to the event as the emcee. With over 230 in attendance, the...
Read MoreTerriann Scheduled to Speak about Health Care Reform at Tri-State HRMA’s 27th Annual Conference
Since the election in November, Terriann Procida has been educating employers about Health Care Reform, specifically the new Play or Pay regulation. Do you know what you need to do to begin budgeting for the 2013-2014 PPACA Provisions? Do you understand how potential penalties associated with Play or Pay may...
Read MoreDo You Monitor Your 3(38) Adviser?
If you don’t, maybe you should. Many people mistakenly assume that when they hire a 3(38) they no longer have to worry about any fiduciary responsibility. They are wrong. While they wouldn’t necessarily be held responsible for the day-to-day decisions made by the 3(38), over time, if they are not...
Read MorePPACA’s “Affordability” Requirement is Clarified by the IRS
The IRS finalized a rule that clarified that the health coverage “affordability” requirement (that an employee’s premium contribution not exceed 9.5 percent of household income) under the Patient Protection and Affordable Care Act (PPACA) will be based on self-only coverage, according to a Business Insurance online report. Employers with plans...
Read MorePPACA Update: Women’s Preventive Services
Proposed rules that would make it simpler for religious organizations and religious-affiliated not-for-profit organizations like hospitals and schools that have a religious objection to providing contraceptive services were released by the DOL on Feb. 1, 2013. These employers would notify their insurer of their objection, and the insurer automatically would...
Read MoreInnovative Benefit Planning Welcomes Ryan Kastner to the Team!
We are pleased to announce the addition of Ryan Kastner to the Innovative team. Ryan is a graduate from the Perdue School of Business at Salisbury University in Maryland. As an Employee Benefits Consultant, Ryan will be identifying, developing and nurturing potential client relationships in the Greater Philadelphia area. Earning...
Read MorePPACA Update: Minimum Essential Coverage
On Feb. 1, 2013, HHS and the IRS issued two proposed regulations that provide details on the individual shared responsibility requirement. PPACA requires that non-exempt individuals obtain “minimum essential coverage” or pay a penalty. Minimum essential coverage includes individual insurance, Medicare, Medicaid, CHIP, TRICARE, VA and similar government programs, and...
Read MorePPACA Update: IRS Issues Final Regulation on Tax Credits
On Feb. 1, 2013, the IRS issued a final regulation that provides the long awaited answer of whether family members of an employee who has access to affordable self-only coverage are eligible for a premium tax credit/subsidy. The answer is that they are not – if the employee has access...
Read MoreHRA Restrictions Under PPACA
Because PPACA prohibits annual dollar limits on essential health benefits, HRAs that are not integrated with other group health coverage (usually a major medical plan) will not be permitted after Jan. 1, 2014. The January 24, 2013 DOL FAQ states that an employer-provided HRA will not be considered integrated (and...
Read MorePPACA Update: Notice of Exchange Has Been Delayed
The Department of Health and Human Services (HHS), the Internal Revenue Service (IRS) and the Department of Labor (DOL) have recently issued more FAQs and proposed rules that address several employer obligations under the Patient Protection and Affordable Care Act (PPACA). On Jan. 24, 2013, the DOL issued a FAQ...
Read MoreAre You Trying To Stick With A Healthier Eating Plan? If So, What Should You Do When You Go Out To Eat?
Restaurant Strategies When Dining Out Keep this baker’s dozen of tips in mind next time you eat out to help you prevent mindless overeating: Avoid all-you-can-eat restaurants, especially if you’re likely to try to “get your money’s worth” with the sheer quantity of food. This style of dining is no...
Read MoreCOMPLIANCE ALERT! Final HIPAA Privacy Regulations are Published
The Office for Civil Rights (“OCR”) of the U.S. Department of Health and Human Services published its long-awaited final privacy and security regulations (“Final Rule”) under the Health Insurance Portability and Accountability Act (“HIPAA”) on January 25, 2013. The Final Rule becomes effective March 26, 2013, and, in general, covered...
Read MoreInnovative Supports the Samaritan Healthcare & Hospice Gala!
For the third consecutive year Terriann Procida is Chairing the Samaritan fundraising gala. This year the theme is “Set Sail: Samaritan Celebration of Life Gala” and it will take place on Saturday, February 23, 2013 at The Westin Mount Laurel. Samaritan has provided hospice care for more than 55,000 families...
Read MoreWhat All Employers Need to Know About the “Cadillac Tax”
Starting in 2018, employers offering health plans that exceed a certain cost (the total employee and employer cost) would be subject to a 40% excise tax on the amount above that value. For individual coverage, the threshold would be $10,200 and for family coverage the threshold would be $27,500.* The...
Read MoreCoordinating Exchange and Plan Open Enrollments
On Jan. 2, 2013, the IRS issued a detailed rule that, among other things, provides that noncalendar-year plans may amend their Section 125 plans to allow employees to make midyear changes because of PPACA. Open enrollment for the exchanges will begin in October 2013 for a Jan. 1, 2014, effective...
Read MoreHow Will an Employer Know if an Employee Applies for a Premium Subsidy in the Exchange?
On Jan. 14, 2013, the Department of Health and Human Services (HHS) issued another lengthy proposed rule under the Patient Protection and Affordable Care Act (PPACA). Among other things, the proposed rule provides some information on how employers will be notified if an employee applies for a premium subsidy /...
Read MoreTerriann Presents to the Philadelphia Chapter of Women Presidents’ Organization!
As an area business owner herself, and an expert on Health Care Reform, Terriann Procida is honored to present “Health Care Reform: An Update on PPACA Since the Election” to the Philadelphia Chapter of Women Presidents’ Organization. The PPACA provisions present some challenges to employers in deciphering the new regulations...
Read MorePPACA: What Do Employers Need To Do Between Now And January 2014?
The provisions associated with health care reform pose many questions for employers, most importantly, what do I need to do and when? Here is a checklist of items to cross off your list before January 2014: Calculate and pay the Patient Centered Outcome Fee if the plan is self-funded (insurers...
Read MoreStand, Stretch and Move!
A Vanderbilt University study estimated that Americans spend about 55 percent of waking time sitting. That’s about seven and a half hours in a chair every day. A growing body of research shows that long periods of physical inactivity raise your risk of developing heart disease, Type 2 diabetes, cancer,...
Read MoreWhat Should Employers Already Be Doing To Comply With PPACA?
Plans: May not have a lifetime dollar maximum on any “essential health benefit” May not have an annual dollar limit on an “essential health benefit” that is over a certain amount Must cover the employee’s dependent children until the dependent reaches age 26 – even if the child...
Read MoreThanks to the Fiscal Cliff Deal, Roth 401(k) Conversions Are Allowed for All
As part of the fiscal cliff deal employees have been given the ability to take funds in a pre-tax 401(k) account and convert it into a Roth 401(k) account. Prior to this most recent provision in the American Taxpayer Relief Act of 2012, only amounts that were deemed distributable could...
Read MoreHealth Care Reform Update: IRS Proposes Regulations on Employer Penalty
The Internal Revenue Service has released proposed regulations on the health care reform employer “shared responsibility” penalty provision. This is the penalty on “large” employers (those with at least 50 full-time or full-time equivalent employees) that do not provide affordable minimum essential coverage for full-time employees and their dependents and...
Read MoreCompliance Alert! DOL Begins Auditing Group Health Plans for PPACA, GINA and Wellness Program Compliance
Employers that have had their group health plans audited by the Employee Benefits Security Administration (EBSA, the arm of the U.S. Department of Labor that enforces Title I of ERISA) are aware of the broad nature of the document requests and compliance reviews carried out under these audits. The EBSA...
Read MoreIndividual Mandate Tax – What is the Cost for Non-Compliance?
Last June the Supreme Court ruled that PPACA, including the individual mandate, is constitutional. Under the law, individuals are required to purchase health care insurance and if they do not, the penalty will be a tax. In order to avoid this tax, a person must have “minimum essential” coverage. This...
Read MoreHHS ISSUES PROPOSED RULES ON ‘BENEFIT AND PAYMENT PARAMETERS,’ MULTI-STATE PLAN PROGRAM
The following is a summary of proposed regulations. Some or all of the provisions may change when final rules are issued. On Dec. 5 and 7, 2012, the Department of Health and Human Services (HHS) issued two more sets of proposed rules that provide added details on how the Patient...
Read MoreHealth Care Reform Lunch N’Learns a Huge Success! More to come…
In light of the outcome of the November Presidential election, Innovative hosted three Lunch N’ Learn events over the last few weeks at Fleming’s Steak House in Marlton, DelFrisco’s Steak House in Philadelphia and Ruth’s Chris Steak House in Parsippany. We also joined Ultimate Software at a fourth event at...
Read MoreMake Time – and Space – for Workouts
Create a Home Gym Cold weather and short days make it harder to exercise outdoors in the winter. For those times when it’s too wet, too cold or just too dark to work out outdoors, why not retreat to your own home gym? For a minimal investment, you can transform...
Read MoreHIGHLIGHTS OF PROPOSED RULES ON HEALTH INSURANCE MARKET RULES
On Nov. 20, 2012, the Department of Health and Human Services (HHS) issued proposed rules that address a number of health insurance market reforms. The rule is still in the “proposed” stage, which means that there may — and likely will — be changes when the final rule is issued....
Read MoreHIGHLIGHTS OF PROPOSED RULES ON WELLNESS PROGRAMS
On Nov. 20, 2012, the Department of Health and Human Services, the IRS and the Department of Labor jointly issued a proposed rule that addresses how wellness programs may operate under PPACA beginning in 2014. The proposed rule would largely carry forward the rules that have been in effect for...
Read MoreHIGHLIGHTS OF PROPOSED RULES ON ESSENTIAL HEALTH BENEFITS AND ACTUARIAL VALUE
On Nov. 20, 2012, the Department of Health and Human Services (HHS) issued a proposed rule that addresses a number of questions surrounding essential health benefits and determining actuarial and minimum value. This rule is still in the “proposed” stage, which means that there may — and likely will —...
Read MoreCORRECTING OPERATIONAL MISTAKES CAN ELIMINATE FIDUCIARY LIABILITY
Over the past decade, plan sponsors have become familiar with the voluntary correction programs offered by the IRS and Department of Labor, including the Service’s Employee Plans Compliance Resolution System (EPCRS) and the DOL’s Voluntary Fiduciary Correction Program (VFCP). These programs offer formal ways for sponsors to correct certain administrative...
Read MoreHealthy Employees Lead to Wealthy Employees
We all know that employer-sponsored wellness programs are effective at extending quality of life by maintaining good health and reducing health risks that can worsen over time. Companies also obtain financials savings from implementing wellness programs. For instance, for every dollar spent on wellness, medical costs are reduced by $3.27...
Read MoreInnovative Welcomes Michelle Bross!
We are so excited to welcome Michelle Bross to the Innovative team! Michelle comes highly recommended and her extensive background in office administration will be well utilized as Innovative continues to grow. Best of luck in your new role Michelle!
Read MoreCritical Amendment Deadline Approaching for Defined Benefit Plans
Sponsors of single-employer defined benefit pension plans will need to amend those plans soon to comply with a critical requirement of the Pension Protection Act of 2006 (the PPA). As explained more fully below, meeting this deadline is crucial because the IRS has conditioned anti-cutback relief on a timely amendment. ...
Read MoreHealth Plan Design Drives Regional Costs
United Benefit Advisors (UBA), one of the nation’s largest employee benefit advisory organizations, announces more key findings from its 2012 Health Plan Survey. As health care costs continue to increase and recruitment and retention of quality employees becomes more competitive, accurate and detailed benefits benchmarking data is imperative for employee...
Read MoreWhat Employers Need To Know Right Now About Health Care Reform And What The Election Results Mean For PPACA
Maintenance of the status quo in Washington, D.C. (the re-election of Barack Obama, with a Republican majority in the House of Representatives and a Democratic majority in the Senate) means that implementation of the Patient Protection and Affordable Care Act (PPACA) will move forward largely as the law was passed...
Read MoreIn this Election, Health Care Takes Center Stage
By Thomas Mangan, CEO, United Benefit Advisors UBA and CFO magazine weigh in on the health insurance exchange market in the face of health care reform. Today marks a historic milestone in the leadership of America as millions of people head to the polls to elect or re-elect our president....
Read MoreThe Benefits of Napping
Quick Takes Naptime – Not Just for Toddlers Lions nap, dogs nap, even dolphins take brief naps. In fact, 85% of all mammal species are polyphasic sleepers, meaning that they sleep for short periods throughout the day. Generally, humans are monophasic sleepers, meaning we divide the day into two parts,...
Read MorePlay or Pay: Applying the Employer Shared Responsibility Penalties
PPACA calls for two possible penalties, one for not offering “minimum essential” coverage and a different penalty for offering coverage that is considered inadequate because it is not “affordable” and/or it does not provide “minimum value.” (A) The “no offer” penalty applies if the large employer does not offer “minimum...
Read MorePlay or Pay: How Does an Employer Determine Average Hours Worked?
An employer may simply look at its population on a current, month by month basis if it wishes to. However, to avoid the complications that may arise if an employee alternates between working more and less than 30 hours, or to simply reduce calculation frequency, IRS Notice 2012-58 gives an...
Read MoreCOMPLIANCE ALERT: 2013 Annual Benefit Plan Amounts
2013 INFLATION ADJUSTMENTS Following recent announcements by both the IRS and the Social Security Administration, we now know most of the dollar amounts that employers will need to administer their benefit plans for 2013. Many of the new numbers are slightly higher than their 2012 counterparts. For instance, the annual...
Read MorePlay or Pay: How Will An Employer Count Hours?
It is expected that current DOL rules for counting hours for pension plan purposes will be used to count an employee’s hours of service as a full-time employee or full-time employee equivalent. Under these rules, a person is considered to have completed an “hour of service” with each hour for...
Read MoreCOMPLIANCE ALERT! CRITICAL AMENDMENT DEADLINE APPROACHING FOR DEFINED BENEFIT PLANS
Sponsors of single-employer defined benefit pension plans will need to amend those plans soon to comply with a critical requirement of the Pension Protection Act of 2006 (the PPA). As explained more fully below, meeting this deadline is crucial because the IRS has conditioned anti-cutback relief on a timely amendment. ...
Read MoreThe Play or Pay Penalty – How Are Employees Counted Under PPACA?
Determining how many employees you have is important for several purposes under the Patient Protection and Affordable Care Act (PPACA). So far, no final rules have been issued, but on Aug. 31, 2012, the regulatory agencies issued safe harbors for 2014 on several key issues. The agencies have also provided...
Read MoreImportant Information About New Jersey 51-100 Health Benefits Plans
A benefit feature that encourages use of generic drugs will be included in all 51-100 health benefits plans. All Aetna 51-100 new business and renewing plans with December 1, 2012 and later effective dates will include a benefit feature that encourages members to use generic drugs as a first choice....
Read MorePhiladelphia Interactive HR Workshop – “Strategies from Industry Leaders in an Era of Change”
Please join Innovative at the Ultimate Software interactive HR workshop. Innovative’s own Terriann Procida will be featured speaking about how to uncover the hidden risk in your benefit package through advanced analytics and predictive modeling. Your company needs a skilled and forward-thinking HR leader more than ever before. So are...
Read MoreFive Great Whole Grains
This month we’re highlighting five whole grains that have much to offer when it comes to nutrition and flavor. The next time you’re at the supermarket or natural foods store, look for foods made with amaranth, barley, buckwheat, bulgur or quinoa and expand your whole-grain horizons. Barley The Story: Barley...
Read MoreUnited Benefit Advisors Welcomes Terriann Procida as a Board Member!
Terriann will be joining the United Benefit Advisors (UBA) Board of Directors effective January 1, 2013. As one of the nation’s largest employee benefits advisory organizations, UBA is comprised of more than 140 of the most successful and most trusted independent employee benefits advisory firms in North America and Europe. ...
Read MoreCongratulations Liz!
We are proud to announce that today Liz Silver, Innovative’s newest Account Manager, passed the third and final test to obtain her RHU designation. All that hard work paid off Liz! Congratulations on a great accomplishment!
Read MoreDid You Ever Get So Covered In Mud That…
You wondered if you would ever get clean? We did! On Saturday September 15th, teams of warriors came together at the New Jersey Motorsports Park to raise money for cancer research and to honor cancer survivors in a tribute called the Bill Bottino Mud Run. Just as cancer survivors had...
Read MoreAll That Sneezing Getting You Down?
The weather turns cooler, the leaves turn colors and pumpkins are everywhere. It’s the perfect time to enjoy the outdoors, unless you suffer from allergies. Are your eyes itchy and watery? Do you have a runny nose? Are you coughing? Does your nose itch? Do you have dark circles under...
Read MoreInnovative Speaks at MetLife Stadium!
Thank you Ultimate Software for inviting Innovative to be a part of your interactive HR workshop at MetLife Stadium yesterday in the Toyota Coaches Club! Our own Terriann Procida was asked to be a guest speaker at this fantastic event. Her presentation focused on changing the current reality of cost...
Read MoreNew Jersey Interactive HR Workshop
“Strategies from Industry Leaders in an Era of Change” Please join Innovative at the Ultimate Software interactive workshop. Innovative’s own Terriann Procida will be featured speaking about how to uncover the hidden risk in your benefit package through advanced analytics and predictive modeling. Your company needs a skilled and forward-thinking...
Read MoreMORE GUIDANCE ON “FULL-TIME” EMPLOYEES AND 90-DAY WAITING PERIOD
Starting in 2014, larger employers (generally, those with 50 or more employees) may face “shared responsibility” penalties if any of their “full-time” employees receive subsidized health coverage through an “Affordable Insurance Exchange.” At the same time, virtually all employer health plans will become subject to a 90-day limit on any...
Read MoreDo You Know What You Need To Know About Comparative Effectiveness Research Fees?
Under the Patient Protection and Affordable Care Act (PPACA), health insurers and self-funded plan sponsors will be required to pay a tax called the comparative effectiveness research fee. The proceeds are to be used to support research conducted by a Patient-Centered Outcomes Research Institute. This research will be centered on...
Read MoreIRS Issues Temporary Guidance for Identifying Full-Time Employees and Applying Waiting Periods
On Aug. 31, the IRS issued Notices 2012-58 and 2012-59, which provide safe harbors for 2014 (and perhaps beyond that date) on how to address some of the open questions on how the employer-shared responsibility penalties will apply. The notices affirm that employers that hire new employees who are reasonably...
Read MoreHealth Care Reform, Costs Likely Will Alter the Nature of Wellness
In the wake of the Supreme Court’s ruling on health care reform, the future of employer-sponsored health care insurance remains murky at best. One health trend, though, looks like it’s here to stay as more insurers, employers and workers buy into corporate wellness programs. Yet the makeup of such programs...
Read MoreEmployers Prep for New Moves under PPACA
As the 2013 enrollment time draws near, employers are preparing to jump through a few extra hoops thanks to the recently reaffirmed health care reform law. In addition to the usual notices and benefit communications that employers must prepare and distribute to their employees, the Patient Protection and Affordable Care...
Read MoreHomegrown Superfruits
Blueberries Drive anywhere in the state of Maine in the month of August and you’re likely to find a blueberry festival in progress or at least a roadside stand selling boxes of just-picked wild blueberries. Locals enjoy the little berries by the handful or in pies, muffins, jams, pancakes and...
Read MoreA Surprise for Jeannine!
When Jeannine Bandiera, Innovative Account Manager, arrived at what she thought was a client pre-renewal meeting, she was pleasantly surprised. She entered the beautifully decorated conference room and was showered with baby gifts! Jeannine would like to thank everyone at Engineering Resource Group for their thoughtfulness. Baby Bandiera will arrive...
Read MorePPACA FSA Contribution Limits
• Applies to all employers who sponsor a health flexible spending account (FSA) • Effective as of the start of the 2013 plan year May not change plan year simply to delay application of the limit • Employee salary reduction contribution may not exceed $2,500 per health FSA per year...
Read MoreLEARN WHAT YOU NEED TO KNOW ABOUT PPACA
Nearly all employers will be affected by the Patient Protection and Affordable Care Act (PPACA) — but not necessarily in the same ways. A company’s compliance requirements largely will depend on its size, method of plan funding and other factors. Do you know which provisions apply to you? As a...
Read MoreMURAL ARTS TROLLEY TOUR – A FABULOUS EVENT FOR A GREAT CAUSE!
On Wednesday July 25th, Innovative proudly sponsored the Mural Arts Program Trolley Tour hosted by the Professional Women’s Roundtable. Jane Golden, Director of the Mural Arts Program, is truly a gift to Philadelphia. Through the Mural Arts Program, Jane has used art to inspire change in communities throughout the city...
Read MoreHIGHLIGHTS OF W-2 REPORTING REQUIREMENT
• Must include the value of “employer-sponsored group health coverage” on W-2s beginning with the 2012 W-2 (to be issued in January 2013) • Except that, do not need to include this information if the employer issued fewer than 250 W-2s for the prior calendar year* o This means the...
Read MoreHIGHLIGHTS OF ADDITIONAL MEDICARE WITHHOLDING FOR HIGH EARNERS
• Effective Jan. 1, 2013 • Applies to all employers • Must withhold an additional 0.9 percent of the employee’s share for Medicare/HI (from 1.45 percent to 2.35 percent) once the employee’s wages exceed $200,000 Employer does not match this additional 0.9 percent Additional 0.9 percent is not capped Additional...
Read MoreCamping With Kids
Pick a Campground If you’ve never camped with children before, or you’ve never camped at all, preparing for a night outdoors may seem daunting. Your first step is to research your options: • Assemble a list of campgrounds within an hour or two of home. • Novice campers will want...
Read MoreHHS Report on MLR Provides Breakdown of Upcoming Rebates:
HHS has released a report on the first round of rebates to be provided under health care reform’s medical loss ratio (MLR) requirements. The report contains calendar year 2011 data–insurers are required to pay rebates by August 1, 2012 based on their 2011 MLR. The report provides a detailed breakdown...
Read MoreHealth Care Reform Still Stands – What Do Employers Need To Do Now?
On June 28th, the U.S. Supreme Court upheld the individual mandate and most of the Patient Protection and Affordable Care Act (PPACA). Because the individual mandate was found to be acceptable, most of the rest of the law (including the exchanges and the requirement that larger employers provide minimum coverage...
Read MoreOVERVIEW OF MEDICAL LOSS RATIO REBATES
The Affordable Care Act requires health insurers to spend a minimum percentage of their premium dollars on medical claims and quality improvement. Insurers in the large group market must achieve a medical loss ratio (MLR) of 85%, while insurers in the individual and small group markets must achieve an MLR...
Read MoreSUPREME COURT LARGELY UPHOLDS PPACA
Today, the U.S. Supreme Court upheld the individual mandate and most of the Patient Protection and Affordable Care Act (PPACA). As expected, it was a close decision — 5-4 — with Chief Justice Roberts and Justices Breyer, Ginsburg, Kagan and Sotomayor agreeing that the individual mandate is a permissible tax....
Read MoreInnovative Sponsors A Mural Arts Program Trolley Tour July 25th!
With more than 3,000 murals on display throughout the city, Philadelphia’s often referred to as the “Mural Capital of the World.” After a special visit from Mural Arts Program founder Jane Golden, we’ll hop aboard a trolley to explore the city’s incredible collection of murals with knowledgeable tour guides while...
Read MoreCompliance Alert! PREPARING FOR THE SUPREME COURT DECISION ON HEALTH CARE REFORM
The U.S. Supreme Court is expected to publish its decision on the legality of the Patient Protection and Affordable Care Act, or PPACA (also called health care reform, HCR and ACA), by the end of June. What they will decide is anyone’s guess. Here are the possibilities (in no particular...
Read MoreTHE 2012 UBA HEALTH PLAN BENCHMARKING SURVEY HAS CLOSED AND THE WINNER OF THE NEW 32 GB IPAD IS…
THE WINNERS ARE: Herr Foods, Inc. and PREIT Services, LLC!!! Due to an overwhelming response to our 2012 UBA Health Plan Benchmarking Survey we are happy to announce that we have two winners for the New 32 GB iPad! With over 17,000 plans participating, including more than 100 plans from...
Read MoreHHS Releases Guidance on Exchanges, Including Draft Exchange Blueprint and Rules for Federally Facilitated Exchanges and SHOPs
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...
Read MoreFinal Regulations Address Individual Tax Credit for Coverage Purchased Through Exchange
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...
Read MoreHHS Makes Available Calculator to Assist in Preparing Coverage Examples for SBC
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...
Read MoreBorzi Announces Fee Disclosure Help for Participants
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...
Read MoreWater Precautions for the Backcountry
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...
Read MoreIRS Eases Health Care Reform Law’s $2,500 Limit for Noncalendar-Year FSAs:
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...
Read MoreThomas Mangan Joins UBA As New CEO
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...
Read MoreInnovative Attends the 2012 Community Access Unlimited Golf Outing
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...
Read MoreNew Guidance on Summary of Benefits and Coverage Adds Safe Harbors
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...
Read MoreNAHU Hosts Webinar on Exchanges
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):...
Read MoreMark and Nicole Attend the 8th Annual fi360 Conference in Chicago
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...
Read MoreIs CAM Right For You?
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...
Read MoreInnovative Exhibits at the 26th Annual Tri-State HRMA Conference
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...
Read MoreCOMPLIANCE ALERT!! – IRS PROPOSES METHODS FOR VALUING EMPLOYER HEALTH COVERAGE
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 2012-33then solicit comments on...
Read MoreIRS ANNOUNCES 2013 AMOUNTS for HSAs and HDHPs
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. ...
Read MoreIRS Proposes Regulations on Fees to Fund Patient-Centered Outcomes Research
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...
Read MoreRevised Audit Guidelines
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...
Read MoreHealthy Supermarket Grab-and-Go Meals
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...
Read MoreThe DoL Fights Employers Failing to Remit Contributions
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...
Read MoreState Exchange Regulations Issued
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...
Read MoreSmoking and Your Numbers
Thankfully, smoking is on the decline in the U.S., but still nearly one in five adult Americans is a smoker. Everyone knows that smoking is bad for you. And most people cite lung cancer as the primary reason for quitting. But that isn’t the only reason to quit: •Smoking raises...
Read MoreKnow Your Numbers – Four Steps
You’re up-to-date on your health screenings. You and your doctor have gone over your numbers together. She points out that your BMI, cholesterol and blood pressure have inched up just a bit over the past couple of years and advises you to “watch what you eat” and to “get more...
Read MoreAgencies Issue Guidance on Waiting Periods
Under the ACA, effective for plan years beginning on or after January 1, 2014, a group health plan may not have a waiting period that exceeds 90 days. The ACA’s statutory language raised many questions regarding how this 90-day limit on waiting periods should be measured. Notice 2012-17 continues to...
Read MoreThe Innovative Award Goes To…
Innovative would like to congratulate UBA partner firm principal, Paul Bogumill of Mountain West Benefits in Helena, Montana, for receiving the Innovative Award at the annual Pharmacy Benefit Management Institute conference in Phoenix, Arizona. Paul was the brainchild behind the development of a new, innovative pharmacy benefit called URx. At...
Read MoreAgencies Issue Guidance on Employer Mandate
Employer Shared Responsibility A key element of the ACA is the employer “shared responsibility” provision. This provision, currently scheduled to take effect in 2014, would assess a penalty against certain “applicable large employers” (those with 50 or more full-time employees) that either fail to offer “minimum essential coverage” to their...
Read MoreAGENCIES ISSUE GUIDANCE ON AUTOMATIC ENROLLMENT
The ACA provision on automatic enrollment requires certain large employers (those with more than 200 full-time employees) to automatically enroll new full-time employees in one of the employer’s health benefit plans (subject to any legally permissible waiting period), and to continue the enrollment of current employees in a health benefit...
Read More2012 UBA HEALTH PLAN BENCHMARKING IS NOW OPEN!!!
Participate in the 2012 Survey and Receive a Detailed Benchmarking Analysis The 2011 survey gathered results from 16,421 health plans from 10,744 employers — making it the largest benchmarking survey of employer-sponsored health care plans in the country. The results provided critical national and regional benchmarks that enabled companies to...
Read MoreThe Innovative Way!
Great job by Innovative’s Jeannine Bandiera, who found a way to make a member’s medication affordable! Recently one of our members was made aware of a tier change for the medication that she needs to treat her condition. The insurance carrier moved the medication to the Specialty Drug list from...
Read MoreMilliman Study Highlights the Impact of Medical Loss Ratio Rules on HSAs
A new report by Milliman Inc. says that high-deductible health plans, including those with health savings accounts (HSAs), will likely be more adversely impacted by the medical loss ratio requirements under PPACA than other types of comprehensive medical plans. Consumers who rely on HSA-qualified plans to finance their health care...
Read MoreHHS Releases Guidance Related to Annual Dollar Limit Waivers
On Feb. 13, 2012, the Department of Health and Human Services (HHS) stated a health insurance issuer that has received a waiver of the annual dollar limit requirements pursuant to Section 2711 of the Public Health Service Act for a group health insurance product can sell that product to a...
Read MoreAgencies Finalize Guidance On Summary Of Benefits And Coverage
As explained in our August 2011 article, the health care reforms enacted in March of 2010 will require employer health plans to provide a uniform “summary of benefits and coverage” (SBC) to all plan participants and beneficiaries. The agencies charged with implementing this requirement have now finalized the regulations they...
Read MoreHealthy Skin, Healthy Living
Glowing, spotless, wrinkle-free skin is much valued in our society. We’re willing to spend a lot for that look. It’s estimated that the skin care industry in the U.S. is worth about $43 billion per year. But healthy skin starts from the inside, not just from creams and lotions applied...
Read MoreDOL, HHS and Treasury Issue Technical Release on Automatic Enrollment, Waiting Periods and Employer Shared Responsibility
The Employee Benefits Security Administration (EBSA) has issued Technical Release 2012-01, which provides information on questions from employers and other stakeholders regarding the provisions of the Patient Protection and Affordable Care Act (PPACA) governing automatic enrollment, employer shared responsibility, and the 90-day limitation on waiting periods. These provisions are scheduled...
Read MoreAgencies Release PPACA Final Rule, Guidance and Templates for Summary of Benefits and Coverage (SBC) and Uniform Glossary of Terms
The Departments of Labor, Treasury and Health and Human Services have released final regulations under the Patient Protection and Affordable Care Act (PPACA) that require health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to those with private health coverage. Under...
Read MoreInnovative’s Mark Sulpizio Goes To The Harvard Club
On Wednesday, February 8, 2012 our own Mark Sulpizio attended Federated Investors’ Retirement Security Symposium at The Harvard Club of New York City. This special event was by invitation only and featured The Honorable Bradford P. Campbell as the Key Note Speaker. Mr. Campbell formerly served as the Assistant Secretary...
Read MoreDOL Finalizes, Delays 401(k) Fee Disclosure Rules
After months of delay, the Department of Labor (DOL) has just released final regulations under Section 408(b)(2) of ERISA, requiring retirement plan service providers to disclose information about their services and fees to plan sponsors. In doing so, the DOL delayed the effective date of those rules and made minor...
Read More2012 Fiscal Year Plans Must Adhere to FSA $2,500 Limit
Though not the norm, some Cafeteria Plans (Section 125 plans) are not calendar year plans but instead are fiscal year plans (e.g. February 1-January 31). Be careful if this applies to you because if your fiscal year plans include Health Care Spending Accounts (HCSA), then as the plan sponsor, you...
Read MoreIRS Releases 2011 Form 8941 and Instructions for Claiming
The IRS has released the 2011 version of Form 8941, which is used by eligible small employers to calculate their health care tax credit. Once calculated, the tax credit is claimed as a general business credit on Form 3800 (or by tax-exempt small employers as a refundable credit on Form...
Read MoreHHS Secretary Announces One-Year Delay for Nonprofits with Religious Beliefs in Complying with No-Cost Women’s Preventive Services
After receiving comments on the interim final rule requiring most health insurance plans to cover preventive services for women including recommended contraceptive services without copays, coinsurance or deductibles, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that nonprofit employers who, based on religious beliefs, do not currently provide contraceptive...
Read MoreMore IRS Guidance On W-2 Reporting of Health Coverage
_ Overview of Reporting Requirement _ Before addressing the recent guidance, it is worth noting some key points that have not changed. For instance, this reporting requirement remains optional for 2011, but then required for 2012. Also preserved is a postponement of this requirement for “small” employers. Any employer that...
Read MoreDo You Like To Eat Out?
Our own Terriann Procida is Chairperson for this year’s Samaritan Healthcare & Hospice Gala taking place February 25th in Mt. Laurel, NJ. As part of the fundraiser we are selling raffle tickets for $5 to win 12, $200 Gift Certificates to the following restaurants: Amada, Brio, Caffe Aldo Lamberti, Cafe Madison,...
Read MoreIRS Issues Additional Guidance on Form W-2 Health Care
The U.S. Internal Revenue Service (IRS) has issued Notice 2012-9 to provide additional guidance on the informational reporting to employees of the cost of their employer-sponsored group health plan coverage on Form W-2. The IRS requested public comments on the W-2 reporting requirement in Notice 2011-28. Notice 2012-9 responds to...
Read MoreSoup’s On!
Several studies show that soup eaters end up weighing less than those who don’t eat much soup, according to Penn State nutrition professor Barbara Rolls, co-author of “Volumetrics: Feel Full on Fewer Calories.” “Incorporating soups into a weight-management plan can really help save calories,” she notes. She also likes it...
Read MoreFinal Rule for CO-OPs – Highlights
On Dec. 8, the Centers for Medicare and Medicaid Services (CMS) released the Final Rule produced by the Department of Health and Human Services (HHS) to establish the Consumer Operated and Oriented Plan (CO-OP) Program under Section 1322 of the Patient Protection and Affordable Care Act (PPACA). The following are...
Read MoreEssential Health Benefits: HHS Informational Bulletin
On Dec. 16, the Department of Health and Human Services (HHS) issued a bulletin outlining the approach (and proposed policies) that HHS intends to pursue in rulemaking to define essential health benefits. The bulletin can be found at http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html.
Read MoreEarly Retiree Reinsurance Program Wrapping Up
The Early Retiree Reinsurance Program will cease to be operational in short order. The $5 billion program was created in July of 2010 to help offset employer costs associated with providing health coverage benefits to early retirees and their eligible spouses, surviving spouses, and dependents. From the get-go, experts predicted...
Read MoreHHS Releases FAQs on Implementation of Exchanges, Including Issues Raised by Federally Facilitated Exchanges
On Nov. 29, HHS released 13 Q&As addressing implementation issues for state and federally facilitated Exchanges. The Q&As cover a range of topics including funding responsibility and resources, information exchanges through federally managed data “hubs,” and shared eligibility verification services. Among them are Q&As focused on issues raised by federally...
Read MoreW-2 Reporting Requirements
Requires all employers (including government entities) to include the aggregate cost (whether paid by the employer or the employee) of employer-sponsored health benefits on the employees’ annual Form W-2. The specific value attributable to each benefit is not required. If an employee receives health insurance coverage under multiple plans, the...
Read MoreCMS Releases PPACA Medical Loss Ratio Requirements Including Group Health Plan Rebate Provisions
On Dec. 2, the Centers for Medicare & Medicaid Services (CMS) issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing. Insurance companies that fail to meet the new standard are required...
Read MoreBefore You Go: Healthy Travel Tips
Need a Flu Shot? With all that’s going on at this time of year, getting vaccinated against seasonal flu may be the last thing on your mind. But you don’t want to come down with the flu when you’re away from home. And you certainly don’t want to spread the...
Read MoreFiduciary Luncheons A Success Again!
Innovative would like to thank all of our guests that attended the Fiduciary Luncheons that we hosted last week in Princeton, Parsippany and Philadelphia. Innovative’s own Mark Sulpizio, Accredited Investment Fiduciary®, discussed the impact of the new 408(b)(2) and 404(a) fee disclosure regulations. Mark also touched on what fiduciary best practices...
Read MoreEmployer Health Care Reform Law Communication Mandate Delayed
Employers have more time to comply with rules dictated by the health care reform law that will require them to revamp how they communicate and explain their health care plans. In a notice published Nov. 17, the Department of Labor (DOL) said the reporting requirements would not go into effect...
Read MoreNJ Posting and Notification Requirements for Employers
The NJ Department of Labor and Workplace Development issued a new regulation concerning employer obligations and their record keeping. For employees hired after November 7, 2011 a written copy of the form notification of these regulations must be distributed at the time of hiring. For existing employees a document must...
Read MoreHealth Law May Undermine Marriage
The health reform law could undermine marriage because once people tie the knot, they may no longer be eligible for tax incentives for insurance. The law links the tax credit to household income, so two people whose combined income goes above a certain level will not be able to get...
Read MoreYear-End Notices for Retirement Plans
There are a series of notices regarding retirement plans that must be provided to participants as the end of 2011 approaches. Included in these notices are the following: 1) If a plan sponsor makes “safe harbor” 401(k) contributions, the plan sponsor must provide the participants with a safe harbor notice...
Read MoreCancer Prevention on Your Plate – Quick Takes For Cancer Prevention
Screening tests are one important element of cancer prevention. Healthy lifestyle choices are another. Your cancer prevention strategy should include these positive choices: Don’t neglect cancer screenings: Early detection saves lives. Avoid tobacco: Cutting out tobacco will immediately reduce your risk for cancer of the lung, throat, bladder, kidney, pancreas...
Read MoreHHS Releases Recommendation to Halt CLASS Act
The Obama administration on Friday pulled the plug on a voluntary long-term care program that was part of the health care reform law. “We have not identified a way to make CLASS work at this time,” Health and Human Services Secretary Kathleen Sebelius said. Because the program was voluntary, critics...
Read MorePosting of Employee Rights Notice Extended; Now Required on Jan. 31
The National Labor Relations Board (NLRB) has postponed the implementation date for its new notice-posting rule by more than two months in order to allow for enhanced education and outreach to employers, particularly those who operate small and midsize businesses. The new effective date of the rule is Jan. 31,...
Read MoreNew Site Shows Health Insurance Rate Hikes
Beginning now, consumers across the country can click their state on a federal webpage to see if a health insurer has raised its rates, as well as the company’s reason for doing so. The new site will also include a section where consumers can comment about rate increases. Beginning Sept....
Read MoreIOM Issues Report for HHS Recommending Criteria and Methods
A new Institute of Medicine (IOM) report provides the U.S. Department of Health and Human Services (HHS) with a set of criteria and methods to develop a package of essential health benefits that will cover many health care needs, promote medically effective services and be affordable to purchasers. Certain insurance...
Read MoreJobs Bill Would Cap Employer Exclusion and HRA/HSA Deductions
The release of President Barack Obama’s deficit reduction plan comes just a week after the President submitted to Congress the actual text of his proposed jobs legislation. The bill, S.1549 , would change the tax treatment of employer-sponsored health insurance. Section 401 of the bill limits the value of all...
Read MoreCMS Proposes Updates to Medicare Advantage and Part D Coverage
The Centers for Medicare and Medicaid (CMS) has issued 298 pages of proposed revisions to the Medicare Advantage program and prescription drug benefit program (Part D) that would implement new benefits under the Patient Protection and Affordable Care Act (PPACA) and increase patient protections. The proposals would codify provisions providing...
Read MoreU.S. Plan Would Boost Access to Lab Results
The Obama administration proposed a new rule that would allow patients to have direct access to electronic medical records, including lab results without waiting to hear them from a doctor. At present, patients can only obtain lab results if their physicians provide authorization, or if they reside in a few...
Read MoreCMS Issues Changes to Claims Submissions for Early Retiree Reinsurance Program
The Centers for Medicare and Medicaid Services (CMS) has announced several changes to improve and streamline the process of submitting claims data for Early Retirement Reinsurance Program (ERRP) reimbursement requests. On Monday, Oct. 3, 2011, CMS will begin providing specific, claim line-level feedback to sponsors who submit claim lists through...
Read MoreInnovative Speaks in Dallas!
At the Fall 2011 United Benefit Advisors (UBA) Meeting in Dallas, Innovative’s own Mark Sulpizio and Terriann Procida spoke to over 300 members from across the country. Recognized as experts in the retirement plan industry, they discussed the added scrutiny and fiduciary responsibility for retirement plan sponsors, in light of...
Read MoreInnovative Congratulates Jim Edwards!
Innovative would like to congratulate UBA partner firm president, Jim Edwards of Mountain West Benefits in Helena, Montana, for having been chosen by Employee Benefit Adviser magazine as 2011 Health Plan Adviser of the Year. Mountain West Benefits proudly represented UBA firms with this honor and demonstrated the forward-thinking cost...
Read MoreTibble v. Edison International, A Lesson in Revenue Sharing
When you sponsor a retirement plan you, or someone you appoint, are responsible for making many important decisions associated with the plan such as investment options and service providers. Informed decision making is reliant upon understanding and evaluating the costs associated with the plan. One of the costs inherent in...
Read MoreProposed Regulations to Make Health Insurance Shopping Easier for Consumers
As part of the Patient Protection and Affordable Care Act (PPACA) the Department of Labor and the Department of Health and Human Services has proposed some new regulations centered around clarifying health plan benefits and coverage for consumers. Many consumers feel overwhelmed when trying to decide which plan to take...
Read MoreHealth Law’s Premium Rate-Review Provision
Under a health reform law provision that goes into effect Sept. 1, states and the federal government will scrutinize health insurance company’s proposals for rate increases on individual and small-employer plans. Insurers will be required to submit a seven-page document, justifying the increase to the Department of Health and Human...
Read MoreEBSA FAQ Clarifies End of COBRA ARRA Subsidy
The Department of Labor’s Employee Benefits Security Administration (EBSA) updated its web page to clarify the end of the COBRA ARRA subsidy. FAQ Q1 states that some individuals are eligible to receive the COBRA premium reduction subsidy beyond Aug. 31, 2011. Individuals who qualified on or before May 31, 2010...
Read MoreCBO Predicts Delay In Start Of CLASS Program
The Congressional Budget Office (CBO) anticipates a one-year delay in implementation of the Community Living Assistance Services and Supports (CLASS) Act included in last year’s health reform bill. In its latest periodic update to Congress on the federal budget, the CBO notes that based on the pace of implementation of...
Read MoreNew Rule Requires Non-Union Employers To Notify Employees Of Their Right To Unionize
The National Labor Relations Board (NLRB) has just issued a final rule obligating the vast majority of private sector employers to notify employees of their rights under the National Labor Relations Act (NLRA). The purpose of the notice is to inform employees of their rights to organize, form, join or...
Read MoreConsumer Driven Health Plan Growth Slows; Costs Surpass HMOs
Cinnaminson, NJ, August 29, 2011 -Consumer Driven Health Plans (CDHPs) in the U.S. experienced continued growth this year – albeit at a slower rate than in 2009 and 2010 – according to preliminary results released by United Benefit Advisors (UBA) from its 2011 UBA Health Plan Survey, the nation’s largest...
Read MoreNew Exchange Subsidy, Medicaid Expansion and Premium Tax Credit Regulations Released
The Obama administration put out three proposed rules (comprising 409 pages) on Friday that will be critical to the establishment of health insurance exchanges. Two of the rules came from the Department of Health and Human Services (HHS): The first rule (139 pages) outlines exchange eligibility and employer standards. The...
Read MoreFederal Appeals Court Rules Against PPACA’s Individual Mandate
Since the enactment in 2010 of the Affordable Care Act’s requirement that all Americans must carry health insurance or face a tax penalty there has been controversy over the constitutionality of the mandate. When the White House passed the law the administration argued that the legislative branch has the ability...
Read MoreAffordable Care Act Ensures Women Receive Preventive Services at No Additional Cost
Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced today by the U.S. Department of Health and Human Services (HHS). Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services such as...
Read MoreEBSA Extends 408(b)(2) to April 2012
The Employee Benefits Security Administration, an arm of the U.S. Department of Labor, has extended the effective date for the interim final fiduciary-level fee disclosure rule, 408(b)(2), from July 16, 2011 to April 1, 2012. Initially proposed in the summer of 2010, the Department ruled to enhance the required fee...
Read More$10 Million In Funding Available For Workplace Health Programs
In addition to the President’s Childhood Obesity Task Force, the First Lady’s Let’s Move initiative, and the National Prevention Council, which was formed to design and implement a National Prevention and Health Promotion Strategy, the government has now embarked upon another area of wellness, this time aimed at supporting workplace...
Read MoreVoucher Provision Repealed
After much negotiation and the threat of a government shutdown the budget was passed last week. This is good news for employers as members of Congress agreed to have the Voucher Provision taken out of the Patient Protection and Affordable Care Act (PPACA) in an effort to reduce the budget. ...
Read MoreHHS Provides Illustrative Information Regarding Benchmarks for Essential Health Benefits
The Department of Health and Human Services (HHS) provided illustrative information to complement its Dec. 16, 2011, bulletin on essential health benefits (EHB) under the Patient Protection and Affordable Care Act. The information provides the names of the three largest products in the small group market in each state ranked...
Read MoreSamaritan Hospice Announces Gala
As posted on Patch.com By Patch Staff Email the author January 7, 2011 Samaritan Hospice will hold its 30th annual gala Feb. 26 at The Westin Mt. Laurel, CEO Mary Ann Boccolini announced. “I am pleased that Terriann Procida of Moorestown, President of Innovative Benefit Planning LLC in Cinnaminson agreed...
Read MoreMedicare Secondary Reporting Requirements for HRAs
Beginning 10/1/10, HRA plans are required to report on a quarterly basis all covered HRA participants and dependents that meet specific criteria. The purpose of reporting is to enable CMS to correctly pay for health insurance benefits of Medicare beneficiaries by determining primary vs. secondary payer responsibility. The employee/dependent data...
Read MoreModel Notices on PPACA Grievance and Appeal Rules
The Department of Labor this week published its model notices under the PPACA Claims and Appeals Regulation, providing model notices that can be used in connection with adverse benefit determinations, appeals of adverse benefit determinations, and a final external review decision. DOL also published Technical Release 2010-1, which provides an...
Read MoreNotice Published in Federal Register on Lifetime Income Options for Retirement Plans
The Agencies published in the Federal Register a request for information (RFI) regarding whether, and, if so, how, by regulation or otherwise, it would be appropriate for them to enhance the retirement security of participants in employer-sponsored retirement plans and in individual retirement arrangements (IRAs) by facilitating access to, and...
Read MoreThe Occupational Training Center of Camden County
We recently partnered with the Occupational Training Center in Berlin NJ to help us put together some of our promotional items. We have had great feedback and success on the work they have done for us. The OTC is a great partner to hiring high paid temporary services or running...
Read MorePA Mini-Cobra Extended
On July 9th, Governor Rendell signed House Bill 1251 that included a change to Pennsylvania Mini-COBRA to allow for coverage beyond 9 months if a covered individual is also receiving a federal premium subsidy. This means that individuals who are eligible for the premium subsidy under the American Recovery and...
Read MoreNew Break Time Requirement for Nursing Mothers
The United States Department of Labor’s Wage and Hour Division recently released a Fact Sheet providing guidance on the new break time requirement for nursing mothers. This new requirement took effect when Section 7 of the Fair Labor Standards Act (“FLSA”) was amended by the Patient Protection and Affordable Care...
Read MoreRegulations Issued on Lifetime and Annual Limits
Close on the heels of their regulations concerning grandfathered plans, the Departments of Labor, Health and Human Services (HHS), and Treasury have now released interim final regulations relating to preexisting condition exclusions, lifetime and annual limits, rescissions, and other patient protections under the Affordable Care Act (the “Act”). Lifetime Limits...
Read MoreFiduciary Update – The SEC and Target Date Branding
As discussed at our recent fiduciary luncheon events, the regulatory agencies are continuing to look at target date funds. Last week, the commissioners at the SEC approved new regulations regarding the marketing of target date funds. The agency wants to require the use of a visual aid illustrating the funds...
Read More5500 Efast Filing
As you may already be aware, new regulations were recently passed requiring all sponsors of qualified plans to file their Form 5500 and accompanying schedules electronically beginning January 1, 2010. Hard copies will no longer be accepted, rather will need to be submitted via the Department of Labor’s EFAST2 electronic...
Read MoreInnovative Sponsors 401(k)/403(b) Fiduciary Luncheon
Mark Sulpizio, a founding partner at IBP, presented a workshop on the added fiduciary responsibilities plan sponsors will face due to the upcoming Department of Labor 408(B)(2) regulations at Ruth’s Chris Steak House in Princeton, NJ. The program reviewed what plan sponsors should be doing to prepare for the regulations...
Read MoreUS Dept. of Health & Human Services, Labor & Treasury Issue Regulation on “Grandfathered” Health Plans Under the Affordable Care Act
While the Affordable Care Act requires all health plans to provide new mandated benefits under the law, plans that existed on March 23, 2010 are exempt from some new requirements. The U.S. Departments of Health and Human Services, Labor, and Treasury issued new regulations on “Grandfathered” health plans under the Affordable...
Read MoreInnovative Presents on Healthcare Reform
Terriann Procida, one of our founding partners, had the privilege of delivering an informative talk about Healthcare Reform on Wednesday, June 9th in Philadelphia. She covered topics such as The Patient and Affordable Care Act as well as the Health Care and Education Reconciliation Act of 2010, both of which have...
Read MoreHopeWorks Charity Golf Classic
Innovative Benefit Planning attended the annual HopeWorks Charity Golf Classic on Monday, June 7th at the Laurel Creek Country Club in Moorestown, NJ. HopeWorks seeks to achieve D.R.E.A.M.S. (Dynamic Realizable Efforts to Attain and Maintain Success) for inner-city Camden, NJ youth by expanding the learning opportunities available to them. Innovative, which was one of...
Read MoreNew Website Launched!
Innovative is pleased to announce the launch of our new website. The site will make it easier for clients to register for events, locate previous compliance alerts and most importantly provide us with feedback for our services. So please stop by the site and let us know what you think!...
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