If dealing with your employee benefits has left you wishing your office had a Don Draper-style bar, you are not alone. Benefits fatigue seems to be going around these days, and even the hardiest of benefits managers are finding the thought of another benefits-related news update exhausting. Whatever the reason (I blame Affordable Care Act implementation), give yourself a break with this quick summary of the benefits reminders and deadlines that matter to your business now:
1. Confirm that Business Associate Agreements are Up to Date:
If you are a covered entity under HIPAA or a business that provides services for a covered entity, you are undoubtedly a party to one or more business associate agreements. Final regulations revising parties’ obligations under these agreements were released in January 2013. New agreements were to be in compliance by September 23, 2013, but the regulations allowed an additional year (until September 23, 2014) to get existing agreements into compliance.
Even if the compliance date has passed by the time you read this, take the time to check for updated agreements and update any remaining agreements as necessary.
2. Distribute Summary Annual Reports (SAR) by September 30:
Health plans filing a Form 5500 by July 31, 2014 must distribute the SAR to all plan participants by September 30, 2014. As a reminder, a filing exception exists for those insured plans with fewer than 100 participants. A plan is insured if benefits are paid by an insurance company (like Kaiser or Providence) and not by the employer itself.
3. Distribute Medicare Part D Notice of Creditable Coverage by October 15:
If your plan offers prescription drug coverage, all employees who are Medicare-eligible must receive a notice stating whether the prescription drug coverage is equal or greater in value than the standard coverage available through Medicare Part D. Your insurance provider can advise as to the status of your coverage.
4. Register for a Health Plan Identifier Number by November 5:
Large self-funded plans are required to register for a Health Plan Identifier Number (HPID) by November 5, 2014. (Large here means $5,000,000 in annual claims.)
5. Consider Benefit Changes Now:
While your 2015 medical coverage is probably your immediate focus, now is also a good time to look at your benefits package as a whole and consider whether it is giving your company the best return on investment possible. If your plan operates on a calendar year—look at the dates in your insurance contracts and retirement plan—take the time to meet with your consultants and attorneys now to ensure that you have sufficient time to implement any changes before the end of the year.
6. Get a Handle on Employee Count by December 31:
The pay or play components of the Affordable Care Act’s employer mandate take effect in earnest on January 1, 2015, and covered employers will make their first report to the IRS in early 2016. The single most important thing for employers to understand as pay or play rolls out is employee count, but counting is not as straightforward as summing up the heads in your office.
Rather, the IRS has dictated an employee counting system that takes into account both those employees working 30 or more hours per week (“full-time employees”) and those employees working fewer than 30 hours per week (“part-time employees”):
Number of full-time employees + (the aggregate number of hours worked by part-time employees in a given month divided by 120) = employee count.
Employers within the same “controlled group” are aggregated for counting purposes, so companies owned by a parent corporation and companies that share ownership with one or more other entities may have a higher than expected employee count.
Employers hovering near 50 employees or 100 employees should take special note because these employee counts trigger obligations under the Affordable Care Act. Employers with 100 or more employees are subject to potential penalties if they fail to offer health coverage, or offer health coverage that is either insufficient or unaffordable under the law in 2014. Employers with 50 to 99 employees will not face penalty exposure until 2015, but together with larger employers, they will have a reporting obligation in 2015 for the 2014 tax year.
Employers with questions about their current employee count or anticipated changes in their count should reach out to their benefits attorney or other service providers for more information.
For a more in-depth review of today’s top employee benefits topics, join Iris at Deschutes Brewery in Bend on October 9. More information and registration at barran.com.
Iris Tilley is a Partner with Barran Liebman LLP in Portland, where she advises employers in all aspects of employee benefits. Contact her at firstname.lastname@example.org or 503-276-2155.