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White Papers

Small Employer Healthcare Relief Act Now a Reality

With the December 7, 2016 passage of the long-awaited Cures Act and President Obama now signing it into law, many small employers and their employees can rejoice that an onerous IRS ruling will be overturned. Starting January 1, 2017, small employers that do not offer group health insurance to their employees will have a tool to provide a tax-favored reimbursement to their employees. And more good news: there’s transition relief retroactive for all plan years beginning on or before December 31, 2016 that the onerous penalties announced by the IRS in Notice 2015-17 are no longer in effect.

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Posted on December 08, 2016 by Gary B. Kushner, SPHR, CBP, President and CEO

Possible Implications on HR of a President Trump and Republican Congress

For the next two years, a President Trump bolstered by majorities in both the House and Senate could be expected to make a large number of legislative and regulatory changes that would impact HR, employers, and employees nationally. Only two days after the election, here are some of the possible changes signaled during the 2016 campaign and in various white papers offered by campaign and Congressional staffers.

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Posted on November 10, 2016 by Gary B. Kushner, SPHR, CBP, President and CEO

2017 IRS Limits Announced

As in past years, the IRS has finalized the limits for retirement plans and health and welfare plans.

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Posted on October 22, 2016 by Gary B. Kushner, SPHR, CBP, President and CEO

2016 IRS Limits Announced


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Posted on October 22, 2015 by Gary B. Kushner, SPHR, CBP, President and CEO

HR Implications from the Obergefell Supreme Court Decision on Same-Sex Marriage

In a landmark 5-4 decision issued on June 26, 2015, the US Supreme Court declared the same-sex marriage was legal in all 50 states, and that each state had to recognize a same-sex marriage legally performed elsewhere, either in the US or abroad. The decision was an extension of the 2013 Windsor Supreme Court decision invalidating Section 3 of the Defense of Marriage Act (DOMA), which had significant impact on employer-provided benefits covered by ERISA. The Obergefell decision will require employers to review many of their HR policies and programs.

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Posted on July 24, 2015 by Gary B. Kushner, SPHR, CBP, President and CEO

IRS Grants Temporary Relief for Small Employers and S Corporations on "Employer Payment Plans"

On February 18, 2015, the IRS issued Notice 2015-17, granting temporary relief to small employers paying for individual (rather than group) health insurance coverage for its employees. The relief period covers all of calendar year 2014 and from January 1, 2015 through June 30, 2015. This is a significant development, particularly for 2014, when many small employers weren’t even aware of the more stringent rules issued in 2013 concerning these reimbursements.

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Posted on February 23, 2015 by Gary B. Kushner, SPHR, CBP, President and CEO

Analysis of Health Claims Data Drives Appropriate Plan Design and Targeted Wellness

Today, the analysis of data drives advances in commerce more than nearly anything else. The power of Amazon is less in the products sells and more in the algorithms that determine what you might buy next, and the ability to address that need. The same is true in health care claims data. Data drives the ability for employers and insurers to address trends in claims data via plan design, plan election steerage, incentives and disincentives for use and participation, and targeted wellness programs.

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Posted on August 13, 2014 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

ACA Reporting for Individual and Employer Mandates

Two key items within ACA – the Individual Mandate and the Employer Mandate – require information from employers who offer health coverage to their employees. This information will tell the government who was offered coverage (and who elected it), whether the coverage was comprehensive and met all ACA requirements, and whether that coverage was affordable. That information is required to be provided to the government through two Internal Revenue Code sections—6055 and 6056—by an insurance company and/or employer.

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Posted on August 07, 2014 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

The Forgotten Filing - 5500 Filings for Health and Welfare Plans

Employers who maintain a retirement plan for their employees are very familiar with the requirement to file an IRS Form 5500 and associated schedules each year. However, many employers are unaware that they may also have a 5500 requirement for their health and welfare plans, possibly including health, dental, vision, life insurance, short-term and long-term disability, and health FSA plans. The rules surrounding 5500 filings for health and welfare plans have changed a bit over the years, and remain somewhat confusing for most employers.

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Posted on June 03, 2014 by Ben Cohen, CEBS - Health and Welfare Practice Leader

Employer Mandate for ACA Postponed and Transition Relief

Medium sized and large employers are once again receiving a reprieve from one of the key elements of the ACA, the employer mandate to provide affordable, comprehensive health benefits to full time employees or pay a fine. On Monday, February 10, 2014, the Treasury Department announced that employers with 50 to 99 FTEs will be given until the start of their 2016 plan year (an additional year) to comply. For employers with 100 or more full-time equivalents, the requirement is delayed but in stages. Rather than ensuring that the previously required 95% of full time employees are eligible for coverage to remain compliant in 2015, larger employers will be allowed to offer coverage for that plan year only to at least 70% of their full time employees instead. The change does not affect the individual mandate that went into effect on January 1, 2014.

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Posted on March 12, 2014 by Ben Cohen, CEBS, Practice Leader, Health and Welfare Benefits

New Employer Option for Health FSA Carryover Announced

The IRS announced on October 31, 2013 in IRS Notice 2013-71 one of the largest changes yet to Health FSAs– the ability to allow employees to carryover up to $500 of a Health FSA unused balance! The content and timing was a shock to most, and everyone is scrambling to implement these changes for their clients and their employees. But first, what are the details.

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Posted on November 03, 2013 by Ben Cohen, CEBS, Practice Leader, Health and Welfare Benefits

PPACA Exchange Notice Assistance Available

As you may be aware, an important notice requirement of Health Care Reform (PPACA) is due to be sent out by October 1, 2013, and then to new employees after that.
While certain provisions of PPACA have been postponed for select groups until 2015, the requirement that employers notify ALL employees about the Health Care Exchanges (now called Health Insurance Marketplace) has NOT been postponed. In fact, the Internal Revenue Service recently confirmed (see IRS Notice 2013-45) that this requirement has NOT been postponed.

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Posted on September 03, 2013 by Ben Cohen, CEBS, Practice Leader, Health and Welfare Benefits

Formal Guidance from IRS on Delayed Provisions of PPACA

Initially announced via a Treasury Department blog on July 2, the IRS has issued Notice 2013-45 that officially delay several key elements of the Affordable Care Act (ACA) due to take effect January 1, 2014. The official announcement delays enforcement until January 1, 2015 for certain ACA provisions regarding information reporting rules and the employer responsibility (“play or pay”) penalty for employers with 50 or more full-time equivalents (FTEs).

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Posted on July 29, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

Wellness Rules

On June 3, 2013, significant changes to the wellness rules were released by applicable responsible agencies. The changes are some of the most sweeping to date, and are effective for plan years beginning on or after January 1, 2014 regardless of the plan’s Grandfathered status.

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Posted on July 11, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

Employer Mandate (Pay or Play) and Reporting Requirements Delayed until 2015

On July 2, 2013, the Obama Administration via the Treasury Department issued a notice that enforcement of two key provisions of Health Care Reform/PPACA will be delayed from January 1, 2014 to January 1, 2015.

The two components are 1) that certain employer reporting requirements are delayed; and 2) that a delay in the requirement for employers with 50 or more full time equivalent employees offer affordable, essential health coverage to all full time employees working an average of 30 or more hours per week or pay a penalty.

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Posted on July 11, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

Health Care Reform's New Measurement, Administrative and Stability Periods Design

Health Care Reform, or PPACA, requires employers with 50 or more Full Time Equivalents (FTEs) to offer “affordable” “essential health coverage “to full time employees regularly scheduled to work 30 or more hours per week. For employees who are “regularly scheduled” to work 30 or more hours per week, the determination to offer coverage is pretty straightforward. For current employees who work “variable hours”, or new employees whose expected hours per week are unknown or variable, the calculation becomes a bit more complicated.

Here we will examine the process by which an employer will determine who needs to be offered coverage, or in other words, who is a full time employee.

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Posted on July 02, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

90 Day Eligibility Period

The federal agencies responsible for guidance on PPACA published proposed regulations in the March 21, 2013 Federal Register on a requirement under PPACA that prohibits group health plans and health insurance companies from utilizing any waiting period that exceeds 90 days. This largely mirrors and expands the August 30, 2012 IRS and DOL temporary guidance issued in IRS Notice 2012-59.

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Posted on July 01, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

Health Care Reform's New Employer Exchange Notice

Originally, employers were to be required to provide a notice about the new Health Care Exchanges (now called Marketplaces) to all active employees by March 1, 2013. However, the deadline was delayed until October 1, 2013. This was meant to allow the Marketplaces in each state to become operational prior to the notice delivery (which was not the case in most states on March 1, 2013). With this new guidance, employers must begin preparations to notify employees about the availability of alternative private health insurance through their state’s Exchanges.

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Posted on July 01, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

New Guidance on 90-Day Eligibility Periods and Certificates of Creditable Coverage

Recent guidance has been announced regarding the application of the requirement under PPACA that an eligibility period is no longer than 90 calendar days, and it makes a significant change to a common employer practice.

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Posted on May 23, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

Model Employee Notice on Availability of the Exchange

State Exchanges become effective for individuals on January 1, 2014, providing employees an alternative to employer-based health insurance coverage. As part of Healthcare Reform, all employers subject to the FLSA (which are virtually all employers of one or more) are required to provide current employees and new hires with written notice of the availability of a Health Insurance Marketplace (also called an Exchange).

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Posted on May 22, 2013 by Ben Cohen, CEBS - Practice Leader, Health and Welfare Benefits

What to Include or Exclude in PPACA W-2 Reporting

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on November 06, 2012

COBRA Penalties for "Innocent Mistakes"-A Recent Court Ruling

We talk often about the dangers of COBRA noncompliance. A seemingly simple process can lead to easily made mistakes with significant penalties and claims costs. The recent case, shown below, demonstrates the potential damage for even “innocent mistakes.”

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Posted on November 01, 2012 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

Michigan Public Employer 2013 Health Plan Caps

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on October 07, 2012

Health Care Reform Update: The Supreme Court Has Spoken-Now What?

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on June 28, 2012

Positive Guidance on $2,500 Health FSA Cap Update for 2013 (And Some Maybe Even Better News)

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on June 04, 2012

New W-2 Reporting Guidance under Health Care Reform

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on February 14, 2012

New Summary of Benefits and Coverage (SBC) Rules

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on February 13, 2012

Benefit Changes in Michigan

Several new laws are in effect for 2012 after Michigan legislators pass bills regulating taxes on Medicaid plans and capping public employee contributions toward health benefits.

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Posted on September 27, 2011 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

Summary of Benefits and Coverage and Uniform Glossary

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on September 27, 2011

Exemption for Removal of Annual Dollar Cap Requirement on HRA Plans

The Affordable Care Act (ACA) removed the ability of group health plans to include an annual dollar cap on essential health benefits. Group health plans were, however, allowed to request a waiver from the Department of Health and Human Services (HHS) for this requirement (with certain other requirements). New guidance has now been issued by HHS regarding the waiver process.

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Posted on September 10, 2011 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

IRS Revises W-2 Reporting Requirements for Health Care Reform

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on June 27, 2011

Public Employer and Employee Savings on Premium Contributions with a Section 125 Plan

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on April 27, 2011

IRS Delays Nongrandfathered Insured Health Plan Nondiscrimination Rules

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on December 08, 2010

Changing Insurance Carriers and Grandfather Status

On November 18, 2010, the U.S. Departments of Labor, Health and Human Services and Treasury issued an amendment to the interim final regulations governing grandfathered health plans. The announcement of this amendment is not much of a shock, but is a welcome clarification nonetheless. The amendment allows an employer with an insured health plan(s) to change insurance carriers and shop for the same coverage without losing their grandfathered plan status. It is important to note, though, that the structure of the new coverage cannot violate one of the other rules for maintaining grandfathered status.

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Posted on November 26, 2010 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

Over-the-Counter Drugs for Flexible Spending Accounts and Health Reimbursement Accounts (HRAs) - NEW

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on September 01, 2010

Health Care Reform: Small Employer Tax Credit

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on August 10, 2010

New Rules for Grandfathered Health Plans

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on July 22, 2010

Impact of Health Care Reform on Section 125 and Flexible Spending Accounts

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on July 21, 2010

Health Care Reform: Coverage for Adult Children to Age 26

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on July 06, 2010

Health Care Reform Signed Into Law – Part I

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on March 23, 2010

Five Things You Need to Do Now to Prepare for Health Care Reform

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on March 01, 2010

HIPAA Notice of Privacy Practices Reminder

By Ben Cohen, CEBS
Practice Leader - Health and Welfare Benefits

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Posted on October 01, 2007

Diagnosing the Ills of Health-Care Coverage

Employee-benefits experts say there is no immediate end in sight to continual increases in health-care premiums, and a lot of people are to blame for that.

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Posted on October 26, 2006 by JANE C. PARIKH, KALAMAZOO GAZETTE

IRS Issues Final Health Savings Account (HSA) "Comparability" Regulations

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on August 01, 2006

More Good News on Health Savings Accounts: DOL Rules HSAs Not ERISA Plans

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on May 01, 2006

Prescription Drug Plans: Medicare Part D Requirements

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on May 01, 2006

Clarifying the HIPAA Compliance Confusion: What Do You Need to Do?

By 2004 all group health plans will be required to implement HIPAA privacy protections, policies, procedures and authorizations to protect individual’s health information.

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Posted on April 13, 2006 by BEN COHEN, CEBS, PRACTICE LEADER, HEALTH AND WELFARE BENEFITS

Health Savings Accounts: More IRS Guidance

By Gary Kushner, SPHR, CBP
President and CEO, Kushner & Company

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Posted on March 29, 2006

Analysis of Marsh & McLennan Charges

In light of the charges facing March & McLennan, employers will want to follow certain steps be sure they are receiving the best possible benefits coverage at the most reasonable rates.

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Posted on March 28, 2006 by GARY B. KUSHNER, SPHR, CBP, PRESIDENT AND CEO

Health Care Plans: Demographics, Laws, Power of Marketplace Expected to Buffet Employer Health Costs

By Susan Hobbs
Bureau of National Affairs

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Posted on March 16, 2006

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