Ask the Experts: Coordinating Health Benefits with Military Coverage

Question: We recently hired an employee who has health coverage through the military (TRICARE). Our company provides a group major medical plan along with a health reimbursement arrangement (HRA). How will our benefits coordinate with TRICARE?

Answer: TRICARE offers several different health service and coverage programs. For active-duty servicemembers (ADSMs), TRICARE Prime is their primary and only health coverage. There are some differences in TRICARE Prime depending on where the ADSM is stationed, so personnel are advised to review their TRICARE Prime booklet and/or consult with a TRICARE coordinator for details.

Next, for dependents of ADSMs, and retired military and their dependents, any employer-sponsored health coverage is the primary coverage. That means that the employer’s group plan must pay its regular benefits without regard to any possible TRICARE coverage. It appears your new employee is a retired servicemember, so your company’s major medical plan will pay its benefits first, then any available HRA funds may be used to reimburse deductibles or out-of-pocket expenses. Finally, if the employee still has unreimbursed expenses, he may file a claim with TRICARE for possible consideration.

Note that TRICARE also is secondary to Medicare, so if the employee or dependent has both group coverage and Medicare, TRICARE will be the last in line.

Lastly, TRICARE beneficiaries are instructed to inform the TRICARE contractor of all other coverage they have by completing the “other health insurance questionnaire” posted on the TRICARE website. Since TRICARE is always the secondary payer (except from active-duty servicemembers), the TRICARE contractor will not administer claims without first having information about the individual’s other coverage sources.


by Kathleen Berger
Originally posted on ThinkHR.com

California Sexual Harassment Training Update | CA Employee Benefits Advisors

In October 2018, California Governor Jerry Brown signed Senate Bill 1343 modifying the California Fair Employment and Housing Act (FEHA) sexual harassment training requirements. 

Since that time, the California Department of Fair Employment and Housing (DFEH) has provided the following resources:

At the end of 2018, the DFEH released Sexual Harassment and Abusive Conduct Prevention Training Information for Employers answering frequently asked questions in anticipation of employer compliance inquiries, including these two that offer clarification:

Q. By what date must employees be trained? A. Both managerial and non-managerial employees must receive training by January 1, 2020. After January 1, 2020, employees must be retrained once every two years. That means that all employees statewide must be retrained by January 1, 2022.

Q. What if my employees were trained between January 1 and December 31, 2018? A. The law requires that employees be trained during calendar year 2019. Employees who were trained in 2018 or before will need to be retrained.

What does this all mean? Essentially, everyone needs to be trained, retrained, and then some. California lawmakers are clearly, emphatically, yelling on their tiptoes from the top of Mount Whitney about the importance of sexual harassment training and prevention in the workplace.

by Samantha Yurman
Originally posted on ThinkHR.com

Government Shutdown Update: EEOC Closed | California Employee Benefits Agency

government with flag.jpg

The U.S. Equal Employment Opportunity Commission (EEOC) announced that it is closed because of the federal government shutdown. During this period of federal closure, a limited number of EEOC services are available. Staff will not be available to answer questions from the public or to respond to correspondence from the public. The EEOC will accept charges that must be filed in order to preserve the rights of a claimant during a shutdown; however, these charges will not be investigated. The EEOC will not litigate in the federal courts, no Freedom of Information Act requests will be processed, and the following will be cancelled:

  • Mediations.

  • Federal sector hearings.

  • Decisions on federal employees’ appeals of discrimination complaints.

  • Outreach and education events.

Moreover, all EEOC digital portals will be closed and will not be accessible to the public. It is unclear how the shutdown will impact the opening date for the 2018 EEO-1 filing website; however, experts anticipate a delay in its availability and that the expected March 31, 2019, deadline for 2018 EEO-1 filings will be extended. ThinkHR will continue to monitor EEOC announcements that affect employers.

Read the announcement and contingency plan

 

Originally posted on ThinkHR.com

Managing the Intersection of Workers’ Compensation with Other Leave Regulations | Cupertino Insurance Partners

BRB sign.jpg

You’re ready when the call comes in. Your client’s employee was seriously injured on the job. You reassure the client that your team has them covered, and you outline their workers’ compensation policy provisions, administrative claim filing process, and accident site investigation protocols.

You check in later in the week. As a result of the accident site investigation, the employer’s worksite processes are updated, equipment is modified, and employees are being trained to prevent future accidents like this one. Employee training records are updated, the OSHA injury/illness logs are completed, and the safety team is monitoring the new processes and systems.

The employee is not back to work, but is progressing well with medical treatment and is receiving wage replacement provided by the policy. Everything is well documented so that the client is ready in the event of an OSHA or state safety audit/inspection.

The client appreciates the extra service and professional advice you’ve given to make the best of the unfortunate accident. You’re satisfied that this situation is under control and make a note to follow up with them in the next few weeks. Your job on this claim is done … or is it?

Important Leave Details Cannot be Overlooked

Your goal is to advise your clients of all risks affecting their business, and it’s likely you haven’t spent much time thinking about the impact of uninsurable HR-related business risks or opportunities to mitigate them. In this situation with an injured worker, there are other employment laws and benefits considerations besides state workers’ compensation rules that your client should factor in when managing time off and return to work.

Although workers’ compensation eligibility, coverage, and benefits rules vary from state to state, most employees are covered when the occurrence is job-related. Depending upon the employer size and type of injury or illness suffered by the employee, the employee also may be entitled to medical and/or disability-related protections under two federal laws: the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). To make things even more complicated, some states have enacted their own disability and family and medical leave laws, some of which provide greater amounts of leave and benefits than the federal rules. Failure to look at the entire situation and take these laws into consideration can prove costly to your client.

Counsel your client to consider the following:

  • If the employee has a serious health situation requiring time off the job, then FMLA may apply.

  • If the employee is disabled, the ADA may apply.

The bottom line is that when employees need time off because of a medical or disability-related issue, it is important to remember that they may have rights under all of these laws at the same (or different) times for the same illness or injury. Each situation needs to be reviewed very carefully, so that the right amounts of time off to manage the condition are provided, and that benefits, compensation, notifications, and other protections are managed.

Avoidable Mistake #1

The most common mistake that employers make with work-related employee injuries/illnesses: Not considering and/or designating FMLA leave concurrently with a workers’ compensation claim. This can result in legal claims for failure to provide benefits, as well as additional costs to the business.

For the claim you just handled, let’s say that the injured employee is off work on temporary total disability for 16 weeks. His doctor then releases him to return to light-duty work, and your client offers him a light-duty job. If they had not properly designated that employee’s time off as FMLA leave, the employee may be able to reject the offer of light-duty work and then be entitled to up to 12 additional weeks of unpaid FMLA leave. Additionally, your client would also be required to keep the employee on their health insurance through those 12 additional weeks of unpaid leave and return him to his former job when he finally returns to full-duty work.

If the client had designated the leave concurrently at the time of the injury, the FMLA job and benefits protections would terminate after the first 12 weeks, while the employee was still on temporary total disability. The employee would then have four more weeks of workers compensation temporary disability, without FMLA protections for additional time off or benefits continuation beyond the wage replacement and benefits provided under workers compensation.

Here’s why: FMLA is a federal law that provides employees up to 12 weeks of unpaid leave per year for specific reasons, including a serious health condition due to a work-related injury or illness. FMLA applies to:

  • Private employers with 50 or more employees working within 75 miles of the employee’s worksite; and

  • All public agencies and private and public elementary and secondary schools, regardless of the number of employees.

Employees are eligible to take FMLA leave if they have:

  • Worked for their employer for at least 12 months;

  • Worked for at least 1,250 hours over the 12 months immediately prior to the leave; and

  • There are at least 50 employees working within 75 miles of the employee’s worksite.

Note: The 12 months of employment do not need to be consecutive, which means that any time previously worked for the same employer can be used to meet the requirement unless the break in service lasted seven years or more. Some exceptions apply.

Within the context of a work-related injury or illness, the most common serious health conditions that qualify for FMLA leave are:

  • Conditions requiring an overnight stay in a hospital or other medical care facility; and

  • Conditions that incapacitate the employee for more than three consecutive days and have ongoing medical treatment (either multiple appointments with a healthcare provider, or a single appointment and follow-up care such as prescription medication).

Generally, basic first aid and routine medical care are not included unless hospitalization or other complications arise.

Employers must also consider compliance with state “mini-FMLA” laws that cover an employee’s serious health condition. California, Connecticut, Maine, Oregon, Rhode Island, Vermont, Washington, Wisconsin, and the District of Columbia have enacted medical leave laws impacting private employers. Massachusetts medical leave law provides for leave benefits beginning January 2021, with proposed regulations to be published in March 2019. Other states are considering similar laws.

Avoidable Mistake #2

The second common mistake that employers make with work-related employee injuries/illnesses: Not considering the ADA requirements for entering into an interactive process for reasonably accommodating an employee’s return to work.

The ADA is a federal law that prohibits covered employers from discriminating against people with disabilities in the full range of employment-related activities. Title I of the ADA applies to employers (including state or local governments) with 15 or more employees and to employment agencies, labor organizations, and joint labor-management committees with any number of employees.

The ADA protects individuals with a disability who are qualified for the job, meaning they have the skills and qualifications to carry out the essential functions of the job, with or without accommodations. An individual with a disability is defined as a person who:

  • Has a physical or mental impairment that substantially limits one or more major life activities;

  • Has a record of such an impairment; or

  • Is regarded as having such an impairment.

The ADA does not set out an exhaustive list of conditions covered by the law, making it more difficult for employers to determine with certainty what conditions actually are considered a disability. These conditions require medical interpretation of the severity of the condition by the employee’s healthcare provider, and it is always a best practice to work with medical and legal experts when in doubt. A good rule of thumb to use in reviewing ADA issues is to look at the medical condition in its entirety. Generally, conditions that last for only a few days or weeks and are not substantially limiting with no long-term effect on an individual’s health — such as basic first aid, broken bones, and sprains — are not considered disabilities under the Act.

The ADA does not specifically require employers to provide medical or disability-related leave. However, it does require employers to make reasonable accommodations for qualified employees with disabilities if necessary to perform essential job functions or to benefit from the same opportunities and rights afforded employees without disabilities. Accommodations can include modifications to work schedules, such as leave. There is no set leave period mandated because accommodations depend on individual circumstances and should generally be granted unless doing so would result in “undue hardship” to the employer.

One of the most common questions — and one of the most difficult to answer — is the definition of what is considered a reasonable accommodation.

In the real world, the definition of what is a reasonable accommodation varies and is based on several factors. Examples include: making existing facilities accessible; job restructuring; part-time or modified work schedules; acquiring or modifying equipment; changing tests, training materials, or policies; providing qualified readers or interpreters; or reassignment to a vacant position. Determining what is reasonable and does not cause undue hardship to the business can be difficult, so be sure to consult with experts and provide documentation regarding why an accommodation would be unreasonable for the business.

The Department of Labor (DOL) suggests that every request for reasonable accommodation under the ADA should be evaluated separately to determine if it would impose an undue hardship, taking into account:

  • The nature and cost of the accommodation needed;

  • The overall financial resources of the company, the number of employees, and the effect on expenses and resources of the business; and

  • The overall impact of the accommodation on the business.

There are two issues that arise with returns to work that are risky for employers: (1) 100 percent healed policies and (2) light-duty rules.

Regarding 100 percent healed policies, employers cannot require an employee to be completely healed before returning to work because those rules violate the ADA’s requirements to allow workers to use their right to an accommodation. Even if the employee is not 100 percent healed, he or she could possibly still work effectively with an accommodation.

Employers may create light-duty positions as a reasonable accommodation under the ADA or as part of the return-to-work plan from workers compensation. The goal is to get employees back to work at 100 percent of the productivity that they had before the injury, and there are times when a light-duty position might be the next step, with lighter physical requirements and reduced productivity expectations.

Caution your clients to design the light-duty position to meet the physical requirements of the partially healed worker, so that there will be no physical reason for the employee to refuse the light-duty position.

Under most workers compensation plans, an employee’s refusal to return to work in a light-duty position that meets his or her medical restrictions can result in termination of workers compensation benefits. Additionally, the ADA does not allow an employee to refuse work that meets the physical requirements of the accommodation.

Without that careful look at the duties of the position as they pertain to the employee’s medical needs, however, the employee can refuse the position and continue to collect benefits until he or she is able to perform the requirements of the position.

Steps for Success

While these laws have different goals, medical circumstances create overlaps between them. It is important to understand the rules and benefits in order to manage them correctly and avoid the risk of legal challenges and more expensive or longer leaves.

Advise your clients to:

  • Designate FMLA leave for eligible employees concurrently with the workers compensation claim.

  • Keep in touch with injured or ill employees throughout their leave.

  • Manage pay and benefits according to each situation.

  • Carefully evaluate requests for intermittent time off, light duty, or other modified work.

  • Consult with your legal advisors and insurance carriers regarding special situations.

  • Handle returns to work and reinstatement of benefits in accordance with the laws.

 

by Laura Kerekes
Originally posted on ThinkHR.com

Ask the Experts: Federal Survey of Employer Health Plans | Cupertino Insurance Consultants

edited.jpg

Question: Our company received a survey from the U.S. Census Bureau asking about the health coverage we offer to employees, how much it costs, etc. Is this an official survey? Do we have to provide the information?

Answer: It appears your company has been randomly selected for the federal government’s Medical Expenditure Panel Survey (MEPS). Here is a sample of the 2018 survey.

The U.S. Census Bureau conducts a variety of studies on different schedules. The most widely known one is the once-a-decade census of the entire U.S. population, but the Bureau also conducts surveys every year of randomly-selected individuals and businesses on different topics. It has used the MEPS for several years to collect data on health insurance spending, the availability of employer-provided coverage, costs paid by employers and workers, and to study trends over time. Policy makers and health care researchers use the data in aggregate form, while each participant’s data is kept confidential.

It is your choice whether to respond to the MEPS. There is no penalty if you do not answer some of the questions or if you decide not to return the survey at all. Your participation is entirely voluntary.

To learn more about the MEPS, see the FAQs that the Census Bureau has prepared for businesses.

 

by Kathleen Berger
Originally posted on ThinkHR.com

7 Ways to Have Self-Control, Even in the Hardest Situations | California Benefits Advisors

What would change if you had more self-control? Would you meet your fitness goals? De-escalate tense situations? Finally stop procrastinating on work projects? Although it can seem impossible to gain any more discipline than you already have, willpower can be exercised regularly just like your muscles. There are a few ways you can gain control when you really need it. When it comes to eating, exercise, anger and more, here are some common "tempting" scenarious followed by tips on how to strengthen your resolve.

1. Resisting Junk Food

From the grocery store to fast-food ads, one thing is for sure: Junk food is everywhere. Overcome the temptations of unhealthy foods by changing your self-talk. First, stop thinking, “I can’t eat this” (something unhealthy), and replace it with, “I can eat that” (something healthy), says Kelly Milligan, naturopath and chef. It removes the restrictive feeling and allows for a more stress-free, positive mindset.

Second, think past the immediate craving and ask yourself, “How will I feel after eating this? Will this help me get closer to my goals?” This way you are changing your approach from arbitrarily labeling foods as “good” or “bad” to focusing on the value certain foods have for your body.

2. Motivating Yourself to Hit the Gym

One way to stay on the path of exercising regularly is simply putting on your workout clothes! A 2012 study published in the Journal of Experimental Social Psychology found that this can give you the motivation you need to get moving. Still not feeling it? Tell yourself you’ll just work out for five to 10 minutes. You’ll be surprised what you’ll feel like doing once you get started.

And remind yourself why you started. Whether your goal is to gain strength, lose weight, recover from an injury or get healthier, each goal is tied to a specific emotion. Dig deep and envision what it would be like if your goal was met today. Bonus: Exercise can strengthen your willpower in other areas of your life!

3. Stopping the Late-Night Munchies

When straight-up willpower isn’t enough to stop yourself from eating an entire bag of chips before bed (or overeating in general), creating new habits is the way. First things first: Keep yourself fueled throughout the day so you’re not “starving” in the evening.

Then find a distraction from your thoughts of food: talk with a friend, stretch or read. Or try brushing your teeth. You won’t want to eat if your mouth is minty fresh. If you're truly hungry, try a pice of fruit. The American Psychological Association states that glucose (like that found in fruit) is fuel for the brain and that acts of self-control reduce blood glucose levels.

4. Controlling Angry Outbursts

Anger is natural. But it’s what you do with that emotion that matters. It all begins with thinking before you speak or act. Ask yourself if what you're about to say is going to make the situation better or worse. Or take a timeout. You can use the age-old trick of counting to 10 before you speak. It allows your mind to get some emotional distance and lets your brain focus on something else.

If you still feel amped up, try exercising. According to stress physiologist Nathaniel Thom in an article for Psychology Today, exercise can help diffuse the buildup of anger. Exercise gets the feel-good hormones elevated in your brain and presents a calming feeling over your body. After you’ve calmed down, you can find solutions and present your feelings in an unagitated state.

5. Refraining From Hitting Snooze

The snooze button is no friend of self-control. Mel Robbins, author of “The 5 Second Rule,” says in her book that how you wake up and spend the first 30 minutes of the morning determines the productivity of your day. It starts with getting up, waking up and being present in everything you do, Mel says. (In other words, put down your phone!)

According to Robbins, if you have an impulse to act on a goal, you must physically move within five seconds or your brain will kill the idea. So within five seconds of your alarm sounding, spring up and out of bed! Immediately after, begin to think of the positive things this extra morning time will add to your day. Before you know it, you’ll have set the tone for the entire day!

6. Curtailing Frivolous Spending

If you feel you need more control in the spending department, writing down each and every thing you purchase is a great way to see exactly how much is going out and where. At the end of each month, go through your list and see what spending was a “need” and what spending was a “want,” says Paula Pant, money-management expert and creator of AffordAnything.com. Add up the total amount of the “wants” and imagine that money saved up for an emergency fund or a memorable family vacation. This will also allow you to see other not-so-good habits you may have, such as buying junk food or always ordering lunch at work.

7. Actually Accomplishing Your Goals

Set your goals on a vision board where you’ll see them every day. This can be hanging on the wall next to your television or placed by the door of your home so you’ll always have a visual reminder of what your goals are. Read them out loud, and tell yourself you can do this — because you can.

Another way to ensure success is to keep it simple in all areas. If it’s too overwhelming, then you’ll be overwhelmed. Have the mindset of working in baby steps, and celebrate each day that you succeed. With self-control comes the feeling of accomplishment. With accomplishment comes self-confidence. And this cycle helps you keep meeting your goals.

**BONUS** Build Self-Control With Sleep

Another easy way to gain more self-control in any area of your life is to get adequate sleep. A 2011 study published in Organizational Behavior and Human Decision Processes found that a sleep-deprived individual is at increased risk for succumbing to impulsive desires, inattentiveness and questionable decision-making. Basically, it’s much easier to make the right choices when our brains are rested and recharged. (Which you probably know from experience!)

by SJ McShane
Originally posted on LiveStrong.com

Ask the Experts: FMLA Leave and Attendance Incentives | Cupertino Benefits Advisors

Question: We give year-end bonuses based on attendance, and employees with a certain number of absences are disqualified. If an employee took FMLA leave, can we count those absences against them and withhold the attendance bonus?

Answer: Yes, if you apply the rubric used to qualify employees for the bonus consistently across all “equivalent leave status” reasons for absence. For example, if you count days off for vacation, paid time off, jury duty, or military leave as absences for the purpose of determining who receives the bonus, you can also count days taken under Family and Medical Leave Act (FMLA) leave.

The same answer applies to bonuses earned for other goals that may be impacted by FMLA leave, such as sales targets or total numbers of hours worked.

If a bonus or raise is not tied to a specific condition, but rather is a cost of living or annual increase provided by all employees, an employee may not be disqualified on the basis of having taken FMLA leave.

 

Originally posted on ThinkHR.com

Workplace Wellness | CA Insurance Agency

cubicle office.jpg

Picture this: You are sitting at your desk at 3pm and you realize you haven’t gotten up from your chair all day. You look around and see that you’ve been snacking instead of eating a lunch. You have read the same sentence 4 times and still can’t figure out what it means. Your back hurts, your eyes feel dry, and you feel kind of blah. You, my friend, are a victim of the sedentary lifestyle in America. How can we combat this lack of energy and inattentiveness in our workplace? By adopting healthy workplace initiatives, you will reap the benefits of a more engaged workforce and a healthier environment.

 

What’s the problem?

·      The average worker sits 7.5 hours at a desk every day

·      Add in couch time, sitting to eat meals, commute, and sleeping, and it could mean that the average adult is only active for 3 hours in a 24-hour period

·      Prolonged sitting is directly related to higher risk of heart disease, weight gain, and diabetes

·      Poor posture can lead to chronic health issues such as arthritis and bursitis

·      Staring at computer screens for long amounts of time lead to higher instances of headaches and migraines

 

What’s the solution?

·      Healthy snack options in vending machines—SnackNation and Nature Box have healthy snack delivery services for offices of all kinds and sizes.

·      Fitness challenges—Encourage different office-wide challenges to promote a more active lifestyle.

o   Incentives for most consecutive gym check-ins

o   Step contests using fitness trackers such as FitBit, Pebble, and AppleWatch

o   Bike or Walk to Work Days

·      Standing desks—Companies such as Varidesk make standing desks or sit/stand desks that lower and raise so that you vary your position during the day

o   Reduces back pain

o   Burns more calories during the day

o   Increases energy

o   Some insurance companies will cover all or portion of the cost if they deem it “medically necessary.”

·      Practice gratitude—keep a daily log of things to be thankful for that day

o   Shown to ease depression, curb appetite, and enhance sleep

o   Spirit of gratefulness leads to more sustainable happiness because it’s not based on immediate gratification, it’s more of a state of mind

·      Get moving during the day—if your office doesn’t have sit/stand desks, schedule time to move each day

o   Stretch time/desk yoga

o   Computer programs to remind you to move such as “Move” for iOS and “Big Stretch Reminder” for Windows

·      Extra happiness in the office—

o   Add a plant

o   Aromatherapy

o   Host a cooking class to encourage healthy meal plans

o   Pet-friendly office days

By showing your employees that you care about their physical and mental health you are showing that you care about them as people and not just employees. This results in higher motivated staff who are healthier. The Harvard Business Review even says that “employers who invested in health and wellness initiatives saw $6 in healthcare savings for every $1 invested.” You cannot always measure ROI on personnel investment but it looks like for workplace wellness, you can! Now get moving and get your office moving!

IRS Extends Deadline for Employers to Furnish Forms 1095-C and 1095-B | California Employee Benefits

On November 29, 2018, the IRS released Notice 2018-94 to extend the due date for employers to furnish 2018 Form 1095-C or 1095-B under the Affordable Care Act’s employer reporting requirement. Employers will have an extra month to prepare and distribute the 2018 form to individuals. The due dates for filing forms with the IRS are not extended.

Background

Applicable large employers (ALEs), who generally are entities that employed 50 or more full-time and full-time-equivalent employees in 2017, are required to report information about the health coverage they offered or did not offer to certain employees in 2018. To meet this reporting requirement, the ALE will furnish Form 1095-C to the employee or former employee and file copies, along with transmittal Form 1094-C, with the IRS.

Employers, regardless of size, that sponsored a self-funded (self-insured) health plan providing minimum essential coverage in 2018 are required to report coverage information about enrollees. To meet this reporting requirement, the employer will furnish Form 1095-B to the primary enrollee and file copies, along with transmittal Form 1094-B, with the IRS. Self-funded employers who also are ALEs may use Forms 1095-C and 1094-C in lieu of Forms 1095-B and 1094-B.

Extended Due Dates

Specifically, Notice 2018-94 extends the following due dates:

  • The deadline for furnishing 2018 Form 1095-C, or Form 1095-B, if applicable, to employees and individuals is March 4, 2019 (extended from January 31, 2019).

  • The deadline for filing copies of the 2018 Forms 1095-C, along with transmittal Form 1094-C (or copies of Forms 1095-B with transmittal Form 1094-B), if applicable, remains unchanged:

    • If filing by paper, February 28, 2019.

    • If filing electronically, April 1, 2019.

The extended due date applies automatically so employers do not need to make individual requests for the extension.

More Information

Notice 2018-94 also extends transitional good-faith relief from certain penalties to the 2018 employer reporting requirements.

Lastly, the IRS encourages employers, insurers, and other reporting entities to furnish forms to individuals and file reports with the IRS as soon as they are ready.



by Kathleen Berger
Originally posted on ThinkHR.com

Happier Holidays, the HR Way | CA Benefits Brokers

Most people, according to a new survey featured in HR Dive, have the greatest sense of belonging in their own homes. That may not be surprising news, but what is interesting is that one third of respondents felt the greatest sense of belonging in their workplace. A significant percentage, 40 percent, attribute that feeling to actions their colleagues and managers take to check in on them, both personally and professionally. Belonging improves employee retention and productivity, certainly, but it requires acknowledgement of diversity and efforts at inclusion.

This critical sense of belonging can be deepened, or hampered, during the holiday season. Beyond secular or national holidays like Thanksgiving and New Year's, the fall and winter months are full of faith-based holidays beyond Christmas. The Society for Human Resource Management has some tips as well as a list of celebrations for the coming months intended to help companies create inclusive workspaces for people of more faiths and cultures. When employees feel valued and known, they are more engaged.

Mutual respect is not only good for morale, it’s good for productivity. Some tips include sharing more about holidays in internal communications, creating luncheons that feature traditional dishes or are mindful of dietary restrictions or fasting practices, or sponsoring a service or volunteer day.

 

by Bill Olson
Originally posted on UBABenefits.com

 

It’s Flu Season...Again | California Benefits Agency

When flu season hits, absenteeism skyrockets and productivity drops. In a recent article, Employee Benefit News points out that the first step is the "ounce of prevention,” the flu vaccine. Providing for vaccination can be a smart benefit to offer employees, and it requires navigating misinformation about the vaccine, motivating employees to act, and contending with supply issues. For employers who want to increase vaccination rates, experts suggest making the process more convenient or incentivizing getting a shot. On-site programs are more effective since they are not only more convenient but also allow employees to be motivated by seeing their coworkers getting the shot. Regardless of approach, careful planning – from scheduling to ordering to addressing employee concerns – can help an office place stay healthier.

Last year’s flu season was the worst on record, per the CDC. Shared spaces and devices make offices and workplaces perfect places for flu germs to spread. As an article in HR Dive shows, 40% of employees with the flu admit to coming to work and 10% attend a social gathering while sick. Should an employee contract the flu, employers need to have policies in place that empower and encourage workers to stay home when sick.

In “Threat of Another Nasty Flu Season Prompts Workplaces to Be Proactive,” Workforce echoes the importance of the flu shot and a no-tolerance policy toward sick employees coming to the office. Policies and a culture that encourage self care over powering through an illness can help foster calling in when needed. The article also reinforces other preventative behaviors like hand washing, staying home while feverish, and coughing into your elbow.

Read more:

HR’s recurring headache: Persuading employees to get a flu shot

40% of workers admit coming to work with the flu

Threat of Another Nasty Flu Season Prompts Workplaces to Be Proactive

 

by Bill Olson
Originally posted on UBAbenefits.com

4 Things Life Insurance Is Not | CA Employee Benefits Agency

Are you confused about life insurance? I don’t blame you. When I first started writing about finances more than a decade ago, my understanding of life insurance was limited.

I knew about life insurance because it was offered through my employer, and I thought a $50,000 policy was a lot of money. I also recognized insurance company names from late-night TV commercials and the occasional bit of junk mail.

I understood “insurance” to be that stuff that you had to have for your car, your home, and your health. The “life” part was a big, blurry blob of “other.” If that’s how you’re feeling, here are a few tips that might help bring things into focus—by understanding the “nots.”

1. Life insurance through work is generally NOT enough. Since learning this myself some years back, I’ve noticed that many people never explore life insurance past what is offered through their work. Policies through work are a great benefit to have, but are usually limited to one- or two-times your salary or a fixed amount like $50,000. Plus the coverage typically ends when your employment there does.

How far will an amount like that go when you consider what’s left behind for your loved ones: the loss of your income and mostly likely debts and bills. What about things like rent or mortgage, child-care and education costs?

An easy way to get a working idea of how much life insurance you need is with a Life Insurance Needs Calculator from a neutral source like www.lifehappens.org/howmuch.

2. Life insurance is NOT a luxury item. Many people have not even considered buying life insurance because they’re convinced it’s a luxury. In a recent study by Life Happens and LIMRA, consumers thought the cost of a 20-year, $250,000 level term life insurance policy for a healthy 30-year-old was three times higher than it generally is. Younger people, in particular, overestimate the cost of a term policy by a factor of five.

If you took a guess at what that policy above would cost, what would you say? It comes out to about $13 or so a month for that policy. Definitely not a luxury—most of us spend more than that on a meal out.

3. Life insurance is NOT just about covering funeral expenses. While covering funeral expenses is very important, and a major reason people purchase it, life insurance does so much more. If something happens to you, life insurance benefits can help replace lost income, or pay off a mortgage, or help ensure a college fund or safeguard a retirement nest egg.

The proceeds of a life insurance policy are generally tax free and can be used for anything your loved ones may need now and well into the future. Amazing, right?

4. Life insurance is NOT just for really healthy people. Granted, life insurance is less expensive the younger and healthier you are, but don’t discount it just because you’re not in triathlete shape!

Many people don’t considering buying life insurance because they think they won’t qualify. But when certain health conditions, such as diabetes or high blood pressure, are under control with a doctor’s guidance or medication, it’s often possible to qualify. You may even be able to get coverage after a heart attack. Just know that it is probably best to work with an experienced insurance agent if you are concerned about a health issue and qualifying for coverage.

Now, if you’re a bit overwhelmed with this information and perhaps don’t know where to start, just know that a life insurance agent will sit down with you at no cost to go over your needs and help you get life insurance coverage to fit your budget. If you don’t have an agent or advisor, go here for suggestions on how to find one. You can also tap the Agent Locator there to find someone in your area.

Remember, the right agent or advisor can help you make sense of the confusion and get you on track for the financial future you want—with the protection your loved ones need.

by Helen Mosher
Originally posted on LifeHappens.org

PCORI Fee Increase for Health Plans | California Benefits Consultants

On November 5, 2018, the Internal Revenue Service (IRS) released Notice 2018-85 to announce that the health plan Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending between October 1, 2018 and September 30, 2019 will be $2.45 per plan participant. This is an increase from the prior year’s fee of $2.39 due to an inflation adjustment.

Background

The Affordable Care Act created the PCORI to study clinical effectiveness and health outcomes. To finance the nonprofit institute’s work, a small annual fee — commonly called the PCORI fee — is charged on group health plans.

The fee is an annual amount multiplied by the number of plan participants. The dollar amount of the fee is based on the ending date of the plan year. For instance:

  • For plan year ending between October 1, 2017 and September 30, 2018: $2.39.

  • For plan year ending between October 1, 2018 and September 30, 2019: $2.45.

Insurers are responsible for calculating and paying the fee for insured plans. For self-funded health plans, however, the employer sponsor is responsible for calculating and paying the fee. Payment is due by filing Form 720 by July 31 following the end of the calendar year in which the health plan year ends. For example, if the group health plan year ends December 31, 2018, Form 720 must be filed along with payment no later than July 31, 2019.

Certain types of health plans are exempt from the fee, such as:

  • Stand-alone dental and/or vision plans;

  • Employee assistance, disease management, and wellness programs that do not provide significant medical care benefits;

  • Stop-loss insurance policies; and

  • Health savings accounts (HSAs).

HRAs and QSEHRAs

A traditional health reimbursement arrangement (HRA) is exempt from the PCORI fee, provided that it is integrated with another self-funded health plan sponsored by the same employer. In that case, the employer pays the PCORI fee with respect to its self-funded plan, but does not pay again just for the HRA component. If, however, the HRA is integrated with a group insurance health plan, the insurer will pay the PCORI fee with respect to the insured coverage and the employer pays the fee for the HRA component.

A qualified small employer health reimbursement arrangement (QSEHRA) works a little differently. A QSEHRA is a special type of tax-preferred arrangement that can only be offered by small employers (generally those with fewer than 50 employees) that do not offer any other health plan to their workers. Since the QSEHRA is not integrated with another plan, the PCORI fee applies to the QSEHRA. Small employers that sponsor a QSEHRA are responsible for reporting and paying the PCORI fee.

PCORI Nears its End

The PCORI program will sunset in 2019. The last payment will apply to plan years that end by September 30, 2019 and that payment will be due in July 2020. There will not be any PCORI fee for plan years that end on October 1, 2019 or later.

Resources

The IRS provides the following guidance to help plan sponsors calculate, report, and pay the PCORI fee:

Originally posted on thinkhr.com

Be the Boss You Want to See in the World | CA Benefits Advisors

An article in the Harvard Business Review suggests that the traits that make someone become a leader aren’t always the ones that make someone an effective leader. Instead, efficacy can be traced to ethicality. Here are a few tips to be an ethical leader.

Humility tops charisma
A little charisma goes a long way. Too much and a leader risks being seen as self-absorbed. Instead, focus on the good of the group, not just sounding good.

Hold steady
Proving reliable and dependable matters. Showing that—yes—the boss follows the rules, too, earns the trust and respect of the people who work for you.

Don’t be the fun boss
It’s tempting to want to be well liked. But showing responsibility and professionalism is better for the health of the team—and your reputation.

Don’t forget to do
Analysis and careful consideration is always appreciated. But at the top you also have to make the call, and make sure it’s not just about the bottom line.

Keep it up!
Once you get comfortable in your leadership role, you may get too comfortable. Seek feedback and stay vigilant.

A company that highlights what happens when leaders aren’t the ones to champion ethics is presented in Human Resource Executive. Theranos had a very public rise and fall, and the author of the article cites the critical role compliance and ethics metrics might have played in pushing for better accountability. The article also makes the case for the powerful role of HR professionals in helping guide more impactful ethics conversations.

One high profile case study of a company recognizing that leadership needed to do more is Uber. Here, leadership realized that fast growth was leading to a crumbling culture. A piece in Yahoo! Sports shows how explosive growth can mean less time to mature as a company. Instead of focusing of partnerships with customers and drivers, Uber became myopically customer-and growth-focused. This led to frustrations for drivers and ultimately a class-action lawsuit. New initiatives, from tipping to phone support to a driver being able to select riders that will get them closer to home, have been rolled out in recent months. These changes have been welcome, but, as the leadership reflected, could have been more proactively implemented to everyone’s benefit. The mindset of bringing people along will also potentially help Uber maintain better ties with municipalities, which ultimately, is good for growth.

Harvard Business Review - Don’t Try to Be the “Fun Boss” — and Other Lessons in Ethical Leadership

Yahoo! SportsHow Uber is recovering from a ‘moral breaking point’

Human Resource Executive An Ethics Lesson

by Bill Olson

Originally posted on ubabenefits.com

Choosing the Right Flexible Benefit for Employees | Cupertino Benefits Agency

Trying to decide which of the many employer-sponsored benefits out there to offer employees can leave an employer feeling lost in a confusing bowl of alphabet soup—HSA? FSA? DCAP? HRA? What does it mean if a benefit is “limited” or “post-deductible”? Which one is use-it-or-lose-it? Which one has a rollover? What are the limits on each benefit?—and so on.

While there are many details to cover for each of these benefit options, perhaps the first and most important question to answer is: which of these benefits is going to best suit the needs of both my business and my employees? In this article, we will cover the basic pros and cons of Flexible Spending Arrangements (FSA), Health Savings Accounts (HSA), and Health Reimbursement Arrangements (HRA) to help you better answer that question.

Flexible Spending Arrangements (FSA)

An FSA is an employer-sponsored and employer-owned benefit that allows employee participants to be reimbursed for certain expenses with amounts deducted from their salaries pre-tax. An FSA can include both the Health FSA that reimburses uncovered medical expenses and the Dependent Care FSA that reimburses for dependent expenses like day care and child care.

Pros:

  • Benefits can be funded entirely from employee salary reductions (ER contributions are an option)

  • Participants have access to full annual elections on day 1 of the benefit (Health FSA only)

  • Participants save on taxes by reducing their taxable income; employers save also by paying less in payroll taxes like FICA and FUTA

  • An FSA allows participants to “give themselves a raise” by reducing the taxes on healthcare expenses they would have had anyway

Cons:

  • Employers risk losing money should an employee quit or leave the program prior to fully funding their FSA election

  • Employees risk losing money should their healthcare expenses total less than their election (the infamous use-it-or-lose-it—though there are ways to mitigate this problem, such as the $500 rollover option)

  • FSA elections are irrevocable after open enrollment; only a qualifying change of status event permits a change of election mid-year

  • Only so much can be elected for an FSA. For 2018, Health FSAs are capped at $2,650, and Dependent Care Accounts are generally capped at $5,000

  • FSA plans are almost always offered under a cafeteria plan; as such, they are subject to several non-discrimination rules and tests

Health Savings Accounts (HSA)

An HSA is an employee-owned account that allows participants to set aside funds to pay for the same expenses that are eligible under a Health FSA. Also like an FSA, these accounts can be offered under a cafeteria plan so that participants may fund their accounts through pre-tax salary reductions.

Pros:

  • HSAs are “triple-tax advantaged”—the contributions are tax free, the funds are not taxed if paid for eligible expenses, and any gains on the funds (interest, dividends) are also tax-free

  • HSAs are portable, employee-owned, interest-bearing bank accounts; the account remains with the employees even if they leave the company

  • Certain HSAs allow participants to invest a portion of the balance into mutual funds; any earnings on these investments are non-taxable

  • Upon reaching retirement, participants can use any remaining HSA funds to pay for any expense without a tax penalty (though normal taxes are required for non-qualified expenses); also, retirees can use the funds tax-free to pay premiums on any supplemental Medicare coverage. This feature allows HSAs to operate as a secondary retirement fund

  • There is no use-it-or-lose-it with HSAs; all funds employees contribute stay in their accounts and remain theirs in perpetuity. Also, participants may alter their deduction amounts at any time

  • Like FSAs, employers can either allow the HSA to be entirely employee-funded, or they may choose to also make contributions to their employees’ HSA accounts

  • Even though they are often offered under a cafeteria plan, HSAs do not carry the same non-discrimination requirements as an FSA. Moreover, there is less administrative burden for the employer as the employees carry the liability for their own accounts

Cons:

  • To open and contribute to an HSA, an employee must be covered by a qualifying high deductible health plan; moreover, they cannot be covered by any other health coverage (a spouse’s health insurance, an FSA (unless limited), or otherwise)

  • Participants are limited to reimburse only what they have contributed—there is no “front-loading” like with an FSA

  • Participant contributions to an HSA also have an annual limit. For 2018, that limit is $3,450 for an employee with single coverage and $6,900 for an employee with family coverage (participants over 55 can add an additional $1,000; also, remember there is no total account limit)

  • Participation in an HSA precludes participation in any other benefit that provides health coverage. This means employees with an HSA cannot participate in either an FSA or an HRA. Employers can work around this by offering a special limited FSA or HRA that only reimburses dental and vision benefits, meets certain deductible requirements, or both

  • HSAs are treated as bank accounts for legal purposes, so they are subject to many of the same laws that govern bank accounts, like the Patriot Act. Participants are often required to verify their identity to open an HSA, an administrative burden that does not apply to either an FSA or an HRA

Health Reimbursement Arrangements (HRA)

An HRA is an employer-owned and employer-sponsored account that, unlike FSAs and HSAs, is completely funded with employer monies. Employers can think of these accounts as their own supplemental health plans that they create for their employees

Pros:

  • HRAs are extremely flexible in terms of design and function; employers can essentially create the benefit to reimburse the specific expenses at the specific time and under the specific conditions that the employers want

  • HRAs can be an excellent way to “soften the blow” of an increase in major medical insurance costs—employers can use an HRA to mitigate an increase in premiums, deductibles, or other out-of-pocket expenses

  • HRAs can be simpler to administer than an FSA or even an HSA, provided that the plan design is simple and efficient: there are no payroll deductions to track, usually less reimbursements to process, and no individual participant elections to manage

  • Small employers may qualify for a special type of HRA, a Qualified Small Employer HRA (or QSEHRA), that even allows participants to be reimbursed for their insurance premiums (special regulations apply)

  • Funds can remain with the employer if someone terminates employment and have not submitted for reimbursement

Cons:

  • HRAs are entirely employer funded. No employee funds or salary reductions may be used to help pay for the benefit. Some employers may not have the funding to operate such a benefit

  • HRAs are subject to the Affordable Care Act. As such, they must be “integrated” with major medical coverage if they provide any sort of health expense reimbursement and are also subject to several regulations

  • HRAs are also subject to many of the same non-discrimination requirements as the Health FSA

  • HRAs often go under-utilized; employers may pay an amount of administrative costs that is disproportionate to how much employees actually use the benefit

  • Employers can often get “stuck in the weeds” with an overly complicated HRA plan design. Such designs create frustration on the part of the participants, the benefits administrator, and the employer

For help in determining which flexible benefit is right for your business, contact us!

by Blake London
Originally posted on ubabenefits.com

Making a Remote Team Work | California Insurance Agents

In a tight labor market, a candidate’s potential commute can make a job more or less attractive. HumanResources reports that a quarter of employees surveyed had left a job because of the commute. When looking at just Millennials, the number jumps to one third. Employees can be choosy, selecting a job that offers more of what they want, and that means less of a commute. Companies can work around this by offering transportation amenities, flexible scheduling or more remote working opportunities.

 Forbes has a recent interview with Tamara Littleton, founder of The Social Element, who’s successfully built a remote team at the social media management agency. She argues culture starts at the top. By treating people well, which includes offering remote opportunities, it sets a tone for the whole company. Creating opportunities for in-person meetings and gatherings balance any isolation that may happen. Then, more regular face-to-face communication, essential to build trust and teamwork, comes via video calls when email might otherwise be the default. Newsletters and webinars keep the team connected and ensure important messages aren’t missed. She can point to the success of her ideas with the hire of many senior team members, willing to sacrifice some pay for more flexibility. 

When implementing remote-friendly strategies, there are plenty of success stories to draw inspiration. Entrepreneur has some tips from Zapier, a company that has been on the forefront of offering alternative working arrangements. In fact, they offer a “de-location” package to encourage employees to move from the cost-prohibitive Bay Area. Tools like Slack facilitate real-time communication, with tools to find ideal meeting times across time zones and channels themed for non-work related conversations. Bots regularly and randomly pair up employees to get a chance to know one another during a brief call. A semi-regular retreat brings people together in person and impromptu video dance parties make slow days more fun.

The takeaway? Being proactive and creative to build remote work policies can get you the employees you want, wherever they may be.

HumanResources
Travelling to and fro office may drive your employees to quit
https://www.humanresourcesonline.net/travelling-to-and-fro-office-may-drive-your-employees-to-quit/

Forbes
How To Build A Culture Of Trust In A Large Remote Team
https://www.forbes.com/sites/brettonputter/2018/10/04/how-to-build-a-culture-of-trust-in-a-large-remote-team/#5d4e5d23188c

Entrepreneur
This Company Hosts Virtual Dance Parties to Help Its 170 Remote Employees Feel Connected
https://www.entrepreneur.com/article/320411


by Bill Olson

Originally posted on ubabenefits.com

The 80s Are Back, According to the NLRB | Cupertino Benefits Agency

On September 14, 2018, the National Labor Relations Board (NLRB) announced in the Federal Register a proposed rule to return its joint-employer standard to its 1984 standard — a standard that stood until 2017. It’s returning to the days of Footloose dancing, Sixteen Candles high school sweethearts, Karate Kid champions, and the principle that a joint-employer of another’s employees applies only if:

  • The employer possesses and exercises substantial, direct, and immediate control over the essential terms and conditions of employment; and

  • The employer has done so in a manner that is not limited and routine.

Under the NLRB’s proposed rule, indirect influence and contractual reservations of authority would no longer be sufficient to establish a joint-employer relationship.

Why Does This Matter to Your Business?

You may be asking, “What does a 1984 image of Kevin Bacon dancing in a barn with a Sony Walkman have anything to do with my business?” (By the way, I heard it wasn’t actually him dancing in that scene but that is completely unverified — so it’s off the record.)

Okay, 1980s hit movies don’t have anything to do with your business, but according to the NLRB, re-establishing the 1984 standard best meets the intent of the National Labor Relation Act’s joint-employer doctrine by not drawing third parties, who have not played an active role in deciding wages, benefits, or other essential terms and conditions of employment, into a collective-bargaining relationship for another employer’s employees.

What Happens Next?

The NLRB invites public comments on all aspects of the proposed rule; however, they must be received on or before November 13, 2018. Feel free to peruse our prior blog articles and law alerts on the joint-employer issue because apparently it is in constant flux. (I’d make a Back to the Future reference here but that movie wasn’t released until 1985.)

And here’s the proposed rule. Have at it . . . because you gotta cut loose.


by Samantha Yurman

Originally posted on thinkhr.com