Lindsay Jones

How to Assess Your Benefit Program Components: A Handy Litmus Test

A common question many of our clients and prospects like to ask is how they can know if their healthcare and benefits program is truly providing value to their employees. It’s a great question. There are so many options when creating a benefits bundle, even the best HR managers may not be able to assemble the optimal mix without a little trial and error.

But there are four simple questions you can ask yourself when evaluating benefit components, to help gauge their effectiveness and value:

Question 1: Is the benefit easily accessed and used by employees?

Employer sponsored benefits should be easily accessible without hoops to jump through, waiting periods, applications, review committees and other red tape subtly designed to lower usage rates. Something as simple as a plan that pays for benefits directly, instead of reimbursing employees a few weeks later, can be the difference between a valuable or worthless perk. Low-wage workers in high turnover industries need benefits to help them with healthcare expenses and other insurance products that may make the difference in financial solvency or financial ruin.

Question 2: Is the benefit payroll deducted?

Employers also need to beware that many niche players in the voluntary benefits market offer products that cannot be payroll deducted. Some companies offering these types of benefits make the pitch to implement these plans with auto deductions from employees’ credit cards, and that makes it“portable,”another big“benefit”to the employee. This is just another distortion. Going around the payroll provider is typically a sign of razor thin margins and should be a red flag that other inadequacies lay beneath the surface.

Question 3: Is the benefit affordable?

Limited Indemnity(Voluntary)insurance is exempted from ACA mandates for major medical coverage. The things that make ACA compliant plans — no lifetime or annual claims caps, for example — do not apply. This means that voluntary insurance products can be provided at a lower cost and the lower cost can be passed on to the employee. Follow the money. If the benefit is expensive with no clear reason, or if the employee could likely afford the plan’s inclusions by saving the premium on their own, then the risk pooling equation is off-kilter and should be questioned.

Question 4: Is the benefit priced at a preferred group rate?

Employers bring group buying power to the table that employees cannot get on their own in the open marketplace. This gives the employer the ability to provide valuable benefits at even more affordable prices for their employees. Many ancillary products like pet insurance, home, auto, identity theft insurance and legal protection are readily available to the consumer online at the same price. Employees who want these coverages are welcome to get them on their own, but an employer adds no value in these cases.

Conclusion

Be sure to ask these hard questions when evaluating benefit options. By choosing flimsy, niche programs, employers are not only reducing value, but they can also seriously undermine HR operations and employee satisfaction.

 

By: Alan Gilbert

MSC Expands Operation in New Colorado Office

Denver Marks the Seventh MSC Office Location 
Medical StaffCARE is proud to announce the opening of our latest office location in Denver, Colorado.
“Colorado is the perfect location for us as we continue to develop MSC’s technology footprint,” said J. Marshall Dye III, President and CEO of MSC. “Denver is a hub for digital entrepreneurs and we are excited to be a part of this city’s
tech-forward business culture.”
The new location is helmed by Todd Fenske, VP of Business Development, bringing 16 years of electronic on-boarding experience to the firm. Fenske joins MSC from the company he co-founded in 2004, Efficient Forms LLC. Efficient Forms and their flagship on-boarding platform, Efficient Hire, is an MSC Integrated Partner and recognized as a leading provider of cloud-based software. Todd’s extensive experience with electronic on-boarding systems will assist Medical StaffCARE in developing integrations with new technology partnerships.
MSC provides benefit solutions to over 2,400 staffing company clients from offices in seven locations nationwide including Greenville, SC; Charlotte, NC; Jacksonville, FL; Chattanooga, TN; Dallas, TX; Denver, CO and San Diego, CA.

IRS Issuing 1094-C/1095-C Penalties

Alert: IRS Issuing Penalties to Employers who Fail to Distribute 1095-C Forms to Employees and who Fail to File 1094/1095-C Forms with the IRS

While IRC 4980H penalties for not offering required ACA health coverage remain in effect, the IRS is beginning to send employers a new set of penalties.

The final days of 2018 have seen the IRS begin assessing penalties to employers who have failed to file forms 1094/1095-C with the IRS timelyand accurately, or who have failed to provide 1095-C forms to employees. These penalties are being administered under IRC 6721/6722 and this is the first year the IRS has begun issuing such penalties.

The proposed penalty assessments for failing to file (or filing incorrectly) the 1094-1095-C forms, or for failing to provide employees with the 1095-C form, are indexed each tax year. The following link highlights the IRS’ penalty rates and, as you can see, the penalties can be quite high.

MSC seeks to keep its clients aware of the penalties and risks concerning important compliance updates. While there hasn’t been a large number of penalty assessments under IRC 6721/6722 to date, we think it is prudent to understand the risks surrounding this penalty, and to speak with your own tax attorney or CPA in helping you to avoid receiving a potential, and costly, IRS assessment.

This message is for informational purposes and is intended to provide our clients with important compliance updates.

 

U.S. District Court Rules ACA Unconstitutional; No Immediate Changes for Employers

U.S. District Judge Reed O’Connor for the Northern District of Texas ruled on Friday that the Affordable Care Act (ACA) is unconstitutional, in its entirety.

A final ruling, however, may be months or even years away. It is important to keep in mind that the Individual Mandate is still in effect for 2018 and does not end until January of 2019. Thus, individuals must still have individual health coverage in order to avoid being penalized.  The other provisions of the ACA, such as the Employer Mandate, continue unchanged until there is an ultimate determination on this controversial and polarizing law.

White House spokesperson Sarah Sanders has stated that “pending appeals, the law remains in effect.” Thus, individuals who recently enrolled in Obamacare insurance programs may (at least for now), be confident that their coverage is unaffected.

The ruling is based on a suit that was filed in February 2018 in the Northern District of Texas.

Friday’s ruling calls into question the legality of the ACA, arguing in part, that the law is unconstitutional since Congress has repealed the tax penalties on individuals who do not have health insurance, also known as the Individual Mandate. The Individual Mandate has long been perceived as the heart of the ACA, and many argue that once that feature is declared unconstitutional, the remainder of the ACA must also be deemed unconstitutional. Legal scholars from both parties have questions as to whether certain portions of the ACA can be severed from the whole and still survive. This legal concept is known as ‘severability’.

This latest ruling traces a portion of its argument to the U.S. Supreme Court’s ruling in 2012 by Chief Justice John Roberts (the GOP swing vote thatupheld the ACA in 2012). That court held that the penalty/tax created for individuals who do not maintain health insurance on themselves is indeed constitutional because Congress does have the power to impose a tax on those without health insurance.

Friday, Plaintiff’s Attorney General Ken Paxton argued that, with the elimination of the health insurance requirement, there is no longer a tax, and therefore the law loses its constitutionality. The theme from the 2012 ruling pertaining to the taxing powers of the government carried over to Friday’s ruling where Judge Reed O’Connor said that the individual mandate requiring people to have health insurance “can no longer be sustained as an exercise of Congress’s tax power.” The judge also concluded that this insurance requirement “is essential to and inseverable from the remainder of the ACA.”

What are the Chances of an All-Out Toppling of the ACA?

Choosing a winner in this battle royale won’t be easy. Many scholars, conservatives and liberals alike, believe that since the authors of the law drafted a severability clause — which holds that killing one part of the law does not necessarily kill the entire law — that it opens the door for this latest ruling to be struck down. Nevertheless, severability clauses will occasionally state that some provisions to the contract or law are so essential to the contract’s purpose and the framer’s intent, that if they are illegal or unenforceable, the contract will be voided.

The plaintiffs, on the other hand, have been fortunate in getting U.S. Justice O’Connor, historically an Obamacare opponent, on their side. The battlefield has been set with various issues yet to be resolved including: Medicaid expansion, individual and employer mandates, pre-existing conditions, severability, and funding.

The case will likely be appealed to the Fifth Circuit Court of Appeals in New Orleans, LA. From there, most legal experts expect it to be referred to the Supreme Court where Trump nominated Supreme Court Justice, Brett M. Kavanaugh will get his first opportunity to take part in arguably one of the most important cases of the 21st century.

While both sides of the aisle gear up for this battle of the ages, one thing is still certain, the ACA is still the law of the land until further notification.