Boon’s Top 5 Healthcare and Wellness Headlines of 2019, So Far

We’re only a few months into 2019 and already the world of health and wellness is buzzing. From seasonal sickness to exciting political moves in the healthcare world, here are the top five headlines that should be on your radar.

1. The Trump Administration is Promoting Price Transparency. 

The President recently signed two bills that can help prevent consumers from overpaying for their prescriptions: the Know the Lowest Price Act and the Patient Right to Know Drug Prices Act. Before the inception of these bills, insurance companies were able to include clauses in their contracts that prevented pharmacists from disclosing drug prices if it meant that the consumer would save money on the prescription by not using their insurance.

The goal of the current administration is to promote drug pricing transparency and to encourage greater consumer awareness and lower drug prices, overall.

2. Watch Your Cholesterol! 

February is American Heart Month and for 2019 the focus of the annual campaign was conversations about cholesterol.

Cholesterol can do a number on our hearts and lead to a host of problems. A healthy diet is one of the best ways to manage our cholesterol. Saturated fats are the worst offender when it comes to high cholesterol. Some tips for avoiding saturated fats include: cooking with olive oil instead of butter, eating more fish, choosing nuts for a snack, and embracing the avocado.

While limiting the amount of fat in your diet is key to maintaining a health cholesterol level, don’t cut it out completely! Just seek out the good fats.

3. ACA Reporting Forms are Due Soon

Under the Affordable Care Act, there are rules under Sections 6055 and 6056 that require employers to provide information to the IRS about the health coverage they offer to their employees.

The following documents must be annually filed with the Internal Revenue Service (IRS)

  • A separate statement for each individual who is provided with minimum essential coverage (for providers reporting under Section 6055), or for each full-time employee (if an applicable large employer, or ALE, is reporting under Section 6056). These forms are 1095-B and 1095-C, respectively
  • A transmittal form, either 1094-B or 1094-C, for all returns filed in a given calendar year.

It’s required that a reporting entity furnish any related statements to individuals. Final forms for 2018 have already been released. To learn more click here!

These forms must be filed with the IRS no later than Feb. 28, 2019, or by April 1, 2019 if filing electronically. The deadline to furnish individual statements for 2018 has been extended by the IRS and was set for March 4, 2019.

4. Second Flu Season is Here!

Did you know that while the flu season officially lasts from October to May, the majority of flu cases occur between December and February? Most people think of the flu season as striking in the fall and right before the holidays. But second flu season is that final half of flu season, when everyone’s guard is down. This means it’s important to not let your guard down when it comes to protecting yourself and your family.

Don’t be fooled, the seasonal flu can make even the healthiest among us sick and can even result in hospitalization. According to the CDC, more than 700,000 people were admitted to the hospital during the 2017–2018 flu season.

The strongest defense against the flu is the flu vaccine, which is recommended by the CDC for anyone older than six months. Also, remember to wash your hands and maintain a healthy diet to keep your immune system in fighting form. Stay healthy and productive, this flu season!

5. EEOC Removes Wellness Plan Incentive Limits

In December 2018, the Equal Employment Opportunity Commission (EEOC) removed the incentive limit rules for wellness plans. The AARP challenged the incentive limit by arguing that it was too high to be consistent with federal laws that require “voluntary” employee participation in wellness programs.

Previously, the rules allowed employer-sponsored wellness plans to offer employees up to a 30% discount of the cost of self-only health coverage, in exchange for certain private medical information. This could also be construed as a penalty of up to 30% for not participating in the wellness plan.

In a civil action against the EEOC by the AARP, the court found that the EEOC failed to adequately explain how it would construe the term “voluntary.” Particularly, it begged the question of at what point is an incentive too large for the program to no longer be voluntary? The court also questioned whether or not incentives could be tied to activities that asked about the medical histories and medical exams of employees.

When the EEOC was unable to provide new regulations and justifications in a satisfactory time. The judge vacated the limit, but in turn, created a gray area surrounding inventive maximums. The 30% safe harbor for incentives shall remain in place.

As of January 1, 2019, the final rules’ guidance on incentive limits for voluntary wellness programs no longer applies.

There is a new level of legal uncertainty that comes with this decision. Employers should carefully consider the level of incentives they use in their wellness programs.

That’s our Top 5! What else will 2019 have in store?

The Boon Blog is your resource for all the latest updates in healthcare, benefits, and all things Boon! Make sure you give us a follow so that you don’t miss a post!

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Posted in ACA, ACA reporting, Affordable Care Act, compliance, employee benefits, employer-sponsored group health plans, health care, health care price transparency, health insurance, prescription drug prices, wellness | Leave a comment

Boon Buzz: 2018 ACA Reporting Deadline is Near!

The final deadline for electronic filing 2018 Affordable Care Act (ACA) reports is April 1, 2019. This will be the final deadline for the reporting season.

Per Sections 6055 and 6056 of the Internal Revenue Service Code, certain employers are required to provide information on the health coverage they offer to their employees. This requirement keeps employers in compliance with the Affordable Care Act and the forms are typically updated on an annual basis.

Check out our earlier blog post for more information on how the 2018 final forms differ from the previous version. Click here to read more.

Section 6056 and corresponding forms 1094-C and 1095-C are intended for applicable large employers (ALE) that offer fully insured health plans. If an employer is qualified as an ALE and also offers a self-insured plan, they are to utilize IRS Forms 1094-C and 1095-C.

For non-ALE employers that offer self-insured health plans, Section 6055 and forms 1094-B and 1095-B are used to meet the reporting obligations.

Each reporting employer must file these forms with the IRS annually. Under Sections 6055 and 6056 the employer must specifically file the following:

  • Form 1095-B or Form 1095-C: A separate statement for each individual that is provided with minimum essential coverage or each full-time employee. Section 6055 applies to employers that offer minimum essential coverage, while Section 6056 is for applicable large employers with full-time employees.
  • A transmittal form for all returns filed in a given calendar year. This is in Form 1094-B or Form 1094-C.

Remember, April 1 is the final deadline for electronic filing of these very important forms.

Employers are expected to comply with a host of reporting and disclosure requirements throughout the year, in connection with their group health plans. It’s a large, but very important task with multiple factors to be considered. We pride ourselves on being experts in these nuances and have an array of helpful solutions for employers.

Click here to learn more about Boon’s compliance expertise.

The Boon Blog is your resource for the latest news and updates from within the healthcare industry. Follow the Boon Blog to keep up with these developments. You can also get the latest on all things Boon on Facebook, Twitter, and LinkedIn.

Posted in ACA, ACA reporting, Affordable Care Act, compliance, employer-sponsored group health plans, health care, health insurance | Leave a comment

Boon Buzz: H.R. 6330 Means Big Change for Small Business

The Small Business Runway Extension Act of 2018 allows growing businesses to be considered “small” for a longer period of time. The stated purpose, per the House Committee on Small Business, is to help small contractors “navigate the middle market as they reach the upper limits of their small size standard.”

On December 17, 2018, President Trump signed the Small Business Runway Extension Act of 2018 (also known as H.R. 6330) into law. In doing so, Section 3(a)(2)(C)(ii)(II) of the Small Business Act was thus amended by extending the period of time under which annual average gross receipts are considered from not less than three years to not less than five years, effectively extending the measurement period for another two years.

If a federal contractor qualifies as a small business, is doing well, and quickly growing, the Small Business Runway Extension Act of 2018 allows it to categorize itself as “small” for a longer period of time in order to establish the presence and infrastructure necessary to be a fierce competitor. This is a benefit to the small business in the same way that it benefits a wrestler to be on the high-end of their weight class. Instead of being a small competitor in a larger class, a business that is allowed to remain “small” still has opportunity to seek assistance and grow, so that when they do enter the next level, they are in their best fighting shape.

This would also, of course, impact a business’s eligibility for any resources and assistance offered by the Small Business Administration and other agencies.

When does H.R. 6330 go into effect?

Since it has been signed into law by the President, H.R. 6330 is immediately in effect, technically. However, there is still some ambiguity as to how the Small Business Administration and other impacted agencies will view and implement the change, absent regulations.

This extension of the Small Business Act does not come without some drawbacks. There is potential that the Small Business Runway Extension Act of 2018 could backfire on companies going the other way; forcing a large company in decline to be categorized as large for longer and keeping them from assistance.

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ACA Affordability Percentages Increase for 2019

The IRS issued Revenue Procedure 2018-34 on May 21, 2018. This action is intended to determine the affordability of an employer’s plan under the Affordable Care Act (ACA) by indexing the contribution percentages in 2019.

So what does this do? For plan years beginning in 2019, employer sponsored coverage will be considered affordable if the employee’s required contribution for self only coverage does not exceed 9.86% of the employee’s household income for the year, for purposes of both the pay or play rules and premium tax credit eligibility. Additionally, for purposes of an individual mandate exemption, the required contribution can’t exceed 8.3% of the employee’s yearly household income.

These affordability percentage updates apply to taxable years and plan years beginning January 1, 2019. It’s worth noting that this is an increase from the affordability percentages set for 2018, which had been a household income percentage of 9.56%. This could mean that some employers have additional flexibility with respect to their employee contributions for 2019.

Still have questions? Let’s break down the ACA.

The Affordability Requirement

The affordability of an employer’s plan can be assessed in three different contexts, under the ACA:

  1. “Pay or Play” rules, also known as employer mandate. This is the employer shared responsibility penalty for applicable large employers
  2. Exemptions from the individual mandate tax penalty for individuals who failed to obtain health coverage
  3. The premium tax credit for low-income individuals to purchase health coverage through an Exchange

Affordable Employer-Sponsored Coverage

Employees and their family members who are eligible for coverage under an affordable employee-sponsored plan are generally not eligible for the premium tax credit. Why is that important? Because the ACA’s employer shared responsibility penalty is triggered when a full-time employee receives a premium tax credit for coverage under an Exchange.

Employer Shared Responsibility Rules

Employer shared responsibility (aka pay or play) rules require Applicable Large Employers (ALEs) to offer affordable, minimum value health coverage to their full-time employees and their dependents.

The affordability of health coverage is the key factor in determining who is subject to these penalties. These rules generally determine affordability of employer-sponsored coverage by reference to the rules for determining premium tax credit eligibility.

For 2019, Rev. Proc. 18-34 increases the affordability percentage to 9.86 percent.

Employers have three options for an affordability safe harbor that they may utilize to measure the affordability of their coverage. These safe harbors are:

  1. Form W-2 wages
  2. The employee’s rate of pay
  3. The federal poverty line for a single individual

ALEs using an affordability safe harbor may rely on the adjusted affordability contribution percentages for 2015 and future years.

The affordability test only applies to annual premiums for self-only coverage and doesn’t include the additional costs for family coverage. Additionally, an employer that offers multiple coverage options is subject to the lowest-cost option that also satisfies the minimum value requirement.

Individual Mandate Exemption

The individual mandate under the ACA formerly required most individuals to obtain acceptable health coverage for themselves and their dependent children or pay a penalty. Individuals who lack access to affordable minimum essential coverage are exempt. For the purposes of the exemption, coverage is only considered affordable if the required contribution for the lower-cost, self-only coverage does not exceed 8.3% of the household income. With respect to family members, coverage is affordable, if the required contribution for lowest-cost family coverage also does not exceed 8.3% of the household income.

The Tax Cuts and Jobs Act reduced the ACA’s individual mandate penalty to zero, effective beginning in 2019. This means that individuals will no longer be penalized for failing to obtain acceptable health coverage, starting in 2019. An individual qualifies for this affordability exemption if he or she must pay more than 8.3% of their household income for minimum essential coverage.

Premium Tax Credit

The ACA provides premium tax credits in order to help low-income individuals and families afford health insurance. Determining the amount of a taxpayer’s premium tax credit is based on the amount of the individuals expected contribution. This value is calculated as a percentage of the taxpayer’s household income.

For decades, Boon has been offering the widest possible range of products and services tailored to the needs of government contracts. From major medical to minimum essential coverage and everything in between, Boon has been providing meaningful benefits from full-time, part time and seasonal employees with the backing of our partnerships with the country’s largest national carriers.

The Boon Blog is your resource for the most current industry updates. You can also follow us on Facebook, Twitter, and LinkedIn for the latest on all things Boon!

Posted in ACA, ACA reporting, Affordable Care Act, compliance, employee benefits, employer-sponsored group health plans, government contractors, health care, health insurance | Leave a comment

Heart Health: The Most Meaningful Valentine of All

Author Benjamin Percy once said, “Matters of the heart make your world worth occupying.” Around Valentine’s Day, that may have you thinking of your sweetheart, but we’re taking a more literal approach.

The heart matters, and that’s why every February we celebrate American Heart Month by raising awareness about heart health.

What is American Heart Month?

American Heart Month is a combined campaign from the American Heart Association and other health associations to raise awareness about heart disease, other ailments of the heart, and to raise general awareness about heart health and disease prevention. For 2019, the spotlight is on talking about cholesterol. Cholesterol is a major risk factor when it comes to heart disease and strokes.

To get to the heart of it all: your heart is essential.

The heart is responsible for pumping blood through our bodies and is a huge support to crucial functions performed by other organs. Did you know heart disease is the number one cause of death in the United States? Our hearts are very vulnerable to risks: cardiac arrest, strokes, and high cholesterol to name a few.

Heart attacks are another common and deadly complication. It’s important to recognize the signs of a heart attack, such as:

  • Chest discomfort
  • Shortness of breath
  • Lightheadedness, nausea, or a cold sweat

What can you do to promote heart health?

Awareness is only half of the battle. It’s vital to take an active interest in your heart health and replace poor habits with healthy ones. Some examples of things you can do to improve your heart health include:

  • Eat a heart friendly diet.
  • Get regular exercise.
  • Avoid smoking.
  • Consume alcohol responsibly and in moderation.
  • Be diligent about managing stress.

Take heart and take care of your heart this February. It’s the best Valentine you can give yourself and the ones you love.

The Boon Blog is your source for updates in the healthcare and benefits industry and all things Boon! Make sure you follow us to keep up with the latest!

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Boon Buzz: 2019 in Benefits, So Far…

We might only be a few weeks into the new year, but 2019 hit the ground running in the world of benefits. Here are the highlights of what should already be on your 2019 radar:

  1. The IRS Has Started to Enforce 2016’s “Pay or Play”

The Internal Revenue Service (IRS) began issuing enforcement letters regarding employer compliance with the shared responsibility rules under the Affordable Care Act, in late 2018.

Only Applicable Large Employers (ALEs) are sent these letters and the determination of whether an ALE may be liable for a penalty is based on the information in forms 1094-C and 1095-C.

If an ALE receives this enforcement letter, they must either agree with the IRS’s determination of  employer shared responsibility or formally disagree before the  penalty is assessed and payment is demanded. ALEs must respond within 30 days from the date of the letter.

  1. FSA Limit Increases in 2019

The Affordable Care Act (ACA) has historically set a dollar limit on health flexible spending account (FSA) contributions. Typically, cost of living adjustments are a consideration in setting this limit and the limit may be increased each year.

The same will be true in 2019. As of November 2018 the FSA contribution limit was increased from $2650 to $2700, effective with the 2019 tax year. This contribution limit increase is par for the course and in step with similar increases made over the past few years.

It’s important for employers that offer FSA’s to their employees to communicate the new 2019 limit during the open enrollment process.

It would appear that the word of 2019 is “Compliance.” At Boon, Compliance is our middle name; it’s also part of our New Year’s Resolution to keep providing competitive benefits solutions for government contractors.

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Boon Buzz: Data Privacy and You

In our technology-driven world, there is nothing more important than respectful and thorough protection of online privacy, keeping your data secure and safe, and enabling trust. In January, we celebrate Data Privacy Day in an effort to educate and empower individuals and businesses to take action and protect their online data.

What is data privacy?

Data privacy, also known as data protection, is the relationship between the collection and distribution of data, as well as the technology, public expectation of privacy, and legal and political issues related to the protection of personal and company data.

Why is data privacy so important?

Your personal information or business information is just as valuable as the money in your bank account and it needs to be protected!

Think about your personal information. What would you be comfortable with a total stranger knowing? Your name and workplace? Maybe. Your address and personal phone number? Hold on a minute. How about your social security number and bank information? Stop right there!

For businesses, not only is all of that personal employee information at risk, but your client lists and important financial information associated with your business can also be exposed. In the wrong hands, your data can lead to devastation.

Check out this blog post for more examples of how cybercriminals hunt for and exploit data.

Data Privacy in the Workplace

It’s imperative employees understand that they play a key role in protecting company data. Here are a few examples of ways your employees can create a data friendly and safe environment:

  • Stay up-to-date and aware of all company privacy and technology policies.
  • Keep work computer updated with the latest security software and operating systems.
  • Exercise caution when working remotely and accessing work information on a personal device.
  • Practice caution when it comes to potential spam emails and be sure to report.

Personal Data Privacy

On average, 1.49 billion people log onto and use Facebook daily. That’s just one social media platform!

Consider that the average internet user is on multiple social media platforms. Factor in that many people are active in online forums and other communities. That says nothing of the online shoppers, entering valuable information and entrusting it to a host of sites. What about the app you downloaded so you could get your horoscope?

That’s a lot of data flying around! Here are some of the top ways to make sure your information is staying safe:

  • Be aware of how websites and apps are collecting and using your information. Read the user agreements.
  • When posting on social media, be mindful of what a post reveals and who could possibly see it.
  • Routinely check security and privacy settings on your favorite apps, devices, and accounts.
  • Only use secure networks when making online purchases.
  • Share information and awareness on how to protect your data.

Stay safe online!

The Boon Blog is your source for industry updates and news and all things Boon! Follow us to get the best of Boon and catch up with us on Facebook, Twitter, and LinkedIn.

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