SALES & MARKETING MANAGER, Page 20 Tag

Many employers rely on the services of a third-party to ensure their benefit plans are in compliance with the sprectrum of applicable state and federal regs. But a new report suggests one particular type of TPA just isn’t hacking it.  

The recent DOL Employee Benefits Security Administration’s (EBSA) report, Assessing the Quality of Employee Benefit Plan Audits, found that just 61% of audits conducted by Certified Public Accounts (CPAs) fully complied with professional auditing standards or had only minor deficiencies.

That means the remaining 41% (nearly half) of the audits the agency reviewed had major deficiencies. And those major deficiencies put $653 billion and 22.5 million plan participants at risk.

The report used a fairly large sample to arrive at those findings. The agency’s report looked at audits of more 81,000 employee benefit plans conducted by more than 7,300 licensed CPAs.

According to DOL Security Phyllis C. Borzi:

The existing patchwork of regulations and rules needs to be overhauled and a meaningful enforcement mechanism needs to be created. The department is proposing, among other measures, legislation that will fix these problems.

Specifically, the DOL is recommending that Congress update ERISA’s definition of “qualified public accountant” to include more requirements and qualifications that would improve the quality of plan audits.

The report also suggests that ERISA should be changed to give its Secretary of Labor the authority to establish accounting principles and audit standards to protect the integrity of employee benefit plans and the benefit security of participants and beneficiaries.

The CPA response

For its part, the American Institute of Certified Public Accountants (AICPA) took responsibility for the DOL’s findings and even offered some steps it was taking to remedy the problem.

One example: Early next year, the AICPA will launch an employee benefit plan certificate program so its practitioners can show their competency. And AICPA vice president for public practice and global alliances, Sue Coffey, said:

Our [AICPA} recently issued Six-Point Plan to Improve Audits will help our members stay focused on achieving the highest level of performance for financial statement audits. Further, our Employee Benefit Plan Audit Quality Center offers members best practice tools and resources that help improve the quality of audit engagement in this area.

An appropriate time and attendance system that meets your organization’s needs can help to eliminate and even prevent many, if not most, of the negative aspects of inaccurate and unreliable timekeeping. Maintaining accurate and reliable time and attendance information makes it easier to keep a handle on labor costs, increases the accuracy of payroll, and reduces administration in the human resources (HR) department, thus saving time. This white paper outlines the top benefits of a time and attendance system and the positive effect automating your time and attendance process can have on your organization.

Click here to learn more!  

You know that one irritating guy who’s late for everything? He could be asking for an ADA accommodation soon.  

According to a story from London’s Daily Mail, a man who has been late for everything in his life — from funerals to first dates — recently had his chronic tardiness diagnosed as a medical condition.

His penchant for lateness was diagnosed as a symptom of his Attention-Deficit Hyperactivity Disorder (ADHD) at a hospital in Dundee, Scotland.

Doctors there said the part of Jim Dunbar’s brain that’s involved in his ADHD also makes it difficult for him to judge how long it takes to do things — like get ready to go to work, apparently.

Dunbar said he didn’t mind his story being made public: ‘The reason I want it out in the open is that there has got to be other folk out there with it and they don’t realize that it’s not their fault.

‘I blamed it on myself and thought ‘Why can’t I be on time?’ I lost a lot of jobs. I can understand people’s reaction and why they don’t believe me.”

According to the Daily Mail story, some psychologists believe that chronic lateness could be a symptom of an underlying mood disorder such as depression, and many ADHD sufferers complain they struggle to keep time.

Just a minute …

The Mail did note some skepticism of Dunbar’s diagnosis among the medical community.

Dr. Sheri Jacobson, psychotherapist and director of Harley Therapy Clinic in London, told the newspaper:

The condition isn’t in the DSM5 (the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders) so I’m not sure you can really call it a condition …

Repeated lateness is usually a symptom of an underlying condition such as ADHD or depression but it can also just be habit.

I think making everyday human behavior into a medical condition is unwise.

We’d certainly agree with Dr. Jacobson. But ADHD can be a disability, correct? And getting to work on time could certainly fall into the category of major life activities.

So when will we see our first disability lawsuit from an employee who’s been axed for showing up late too many times?

If you sponsored a health plan in 2014, Uncle Sam is expecting a check this summer. 

Remember the Patient-Centered Outcomes Research Trust Fund Fee that you started paying in 2013 — if you’re an insurer or self-funded plans sponsor, that is? Well, it’s back again.

All firms subject to the fee — again, insurers or self-funded plan sponsors — are expected to cut the IRS a check by July 31, 2015.

The money is for research conducted on the clinical effectiveness of medical treatments, procedures and drugs.

Those responsible for paying the fee must also file the new IRS Form 720 along with their payments.

Think your off the hook if you sponsor a fully-insured plan? You’re not. The fee and paperwork responsibilities may technically fall on your insurance company, but you can bet it’ll extract its pound of flesh from you by way of higher premiums.

How much?

The fee this year: It has increased from $2 last year to $2.08 per life covered by a health plan that reached year-end in or after October 2014. For plan years ending earlier than October 2014 the fee is still $2.

The fee, which was created by the Affordable Care Act, is tied to inflation, hence the $0.08 up-charge for more recent plans. And that means the fee will continue to increase over the years — until 2020, when the fee is no longer in effect.

To calculate their total liability, plan sponsors and insurers need to use the average number of covered lives during the plan year. And when calculating that figure, plans must include any covered spouses or dependent children covered by the policy.

Example: If an employee has a family plan that covers his spouse and two children, that counts as four covered lives.

In addition, any individuals (and their beneficiaries) covered under COBRA also count as covered lives.

Which plans are exempt?

As with any rule, there are exceptions.

Plans exempt from the fee include:

• dental or vision plans for which a separate policy was written and employee election is needed
• EAP, disease management and wellness programs that provide no significant medical care
• plans covering individuals working outside of the U.S.
• HSAs, and
• certain HRAs and FSAs.

For the first time since 2012, the DOL has rolled out brand new FMLA forms. Here’s what’s new, what isn’t and how long can you expect to use these versions of the forms.  

Following the DOL’s announcement, FMLA Insights Jeff Nowak analyzed the new forms with a fine-toothed comb and discovered not much has changed.

The most notable difference in the updated forms: a new GINA reference. In the instructions to the healthcare provider, which is located on the certification for an employee’s serious health condition, the feds have added the following language:

Do not provide information about genetic tests, as defined in 29 C.F.R. § 1635.3(f), genetic services, as defined in 29 C.F.R. § 1635.3(e), or the manifestation of disease or disorder in the employee’s family members, 29 C.F.R. § 1635.3(b).

The concept of adding GINA disclaimers isn’t in and of itself new. Employment attorneys like Nowak have been urging employers to take this extra step for some time to protect themselves from inadvertent GINA violations. However, the addition of specific language to this FMLA form is new.

Until 2018

The new FMLA forms will be good until the spring of 2018. The DOL is required to submit its FMLA forms every three years to the Office of Management and Budget (OMB) for approval, so that OMB can review the DOL’s information requests and the time employers spend responding to the requests. OMB approved the DOL’s previous FMLA forms in early 2012 for the maximum period of three years.

Here are new FMLA forms:

• WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition (pdf)
• WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition (pdf)
• WH-381 Notice of Eligibility and Rights & Responsibilities (pdf)
• WH-382 Designation Notice (pdf)
• WH-384 Certification of Qualifying Exigency For Military Family Leave (pdf)
• WH-385 Certification for Serious Injury or Illness of Current Servicemember — for Military Family Leave (pdf)
• WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (pdf)

Retroactive calculations are often required in time and attendance applications. The subject of retroactive calculations is an important one because timesheets are often turned in with errors. In other situations, a policy change is made effective retroactively, thus requiring whole groups of timesheets to be recalculated. Download the white paper now!

Click here to learn more!  

The name, “The Affordable Care Act,” doesn’t seem to be doing President Obama’s signature piece of legislation any favors. It appears to have made the law the brunt of employers’ ire because it hasn’t stopped healthcare costs from climbing as the name suggests it would.

As a result, the ACA is public enemy No. 1.

And now, instead of blaming market conditions, which had healthcare costs on the rise long before the law was passed, employers are blaming Obamacare.

One of their biggest beefs: Not only has the law not reduced costs, it has actually added expenses by way of administrative burdens.

How much is Obamacare increasing costs?

A recent survey (PDF) conducted by the Internal Foundation of Employee Benefits Plans revealed that most employers believe the ACA is driving up healthcare costs this year and — worse yet — we haven’t seen the worst of it.

By how much are employers saying the ACA will increase their health benefits costs in 2015?

• By more than 10% — said 8% of employer respondents.
• By 7% to 10% — said 12% of employers.
• By 5% to 6% — said 16% of employers.
• By 3% to 4% — said 23% of employers.
• By 1% to 2% — said 23% of employers.

Seventeen percent of employers said they expect “no change” in their health benefits costs in 2015 due to the ACA, and just 1% said the law will decrease their costs.

The five biggest cost drivers?

• General administrative costs — said 56% of employers.
• Reporting disclosure and notification requirements — said 37% of employers.
• Patient-Centered Outcomes Research Institute fees — said 33% of employers.
• ACA-related plan design changes — said 20% of employers.
• Health insurance provider fees — said 18% of employers.

Worst is still to come

As bad as all that looks for 2015 health benefits costs, the worst of the increases are still to come, according to 71% of employers.

The breakdown looks like this:

• 33% of employers say the largest ACA cost increase will come in 2016.
• 11% believe it’ll come in 2017.
• 27% believe it’ll come in 2018.

The biggest cost driver in the future? Gearing up for the excise “Cadillac Tax” on high-cost health plans, which takes effect in 2018.

Will employers drop coverage?

The good news, at least for employees, is that despite their belief that costs will continue to climb, the majority of employers don’t plan on dropping their health benefits anytime soon.

When asked how likely it would be that they’d still be providing health benefits in five years:

• 52% said it was “very likely”
• 33% said they “definitely will”
• 11% said they were “somewhat likely”
• 3% said they were “somewhat unlikely,” and
• 1% said they were “very unlikely.”

Zero said they “definitely won’t” be providing health benefits five years from now.

The top 5 reasons for continuing to offer coverage:

• To attract talent — said 79% of employers.
• To retain current employees — said 75% of employers.
• To maintain/increase employee satisfaction and loyalty — said 53% of employers.
• To maintain/increase productivity — said 14% of employers.
• To avoid paying penalties — said 14% of employers.

This is how a good idea can turn out badly.  

Seems that restaurant chain Ruby Tuesday posted an internal announcement within a nine-state region (Oregon, Arizona, Colorado, Iowa, Minnesota, Missouri, Nebraska, Nevada, and Utah) for temporary summer positions. The jobs came with company-provided housing and the chance for higher-than-usual earnings, apparently because the restaurants were located in resort areas.

The problem: The announcement stated that only females would be considered, purportedly because of concerns about housing employees of both genders together. Ruby Tuesday only hired women to fill the openings.

And that blew up in the company’s face when two males were denied jobs as servers in the chain’s property in the busy resort town of Park City, Utah. The pair complained to the Equal Opportunity Employment Commission.

Now Ruby Tuesday will pay $100,000 and implement preventative measures to settle a sex discrimination lawsuit brought by the EEOC.

The EEOC filed suit in U.S. District Court after first attempting to reach a voluntary pre-litigation resolution through its conciliation process.

Under the consent decree resolving the suit, Ruby Tuesday will pay employees Andrew Herrera and Joshua Bell a total of $100,000 and take steps to prevent future sex discrimination.

The company will provide training to all of its managers and employees on Title VII and job assignments in the nine-state area covered by the EEOC’s lawsuit for the duration of the three-year decree.  This includes an estimated 1,600 managers and employees at 49 different locations.

Ruby Tuesday will also report its training efforts to the EEOC, and post reminders of this resolution on its website and at its restaurants.