Form 5500 Filing Requirements
Tuesday, May 13, 2014 – 2:00 p.m. ET / 11:00 a.m. PT
Most employee benefit plans are required to file a Form 5500 annually, and penalties for not meeting this obligation can be costly. During this 90-minute basic-to-…
By Lisa Weston, CWC, CWPC
Director of Employee Wellness Promotion
the bagnall company, a UBA Partner Firm
More than 75 cents of every health care dollar spent in the United States goes toward treating chronic diseases such as arthritis, asthma, cancer, cardiovascular disease, and diabetes, according to the Centers for Disease Control and Prevention. Because these conditions are the No. 1 cause of death and disability, and consequently the primary factor in rising health care costs, moving toward prevention-based care will be the key that helps both employers and employees pull health care costs back from the edge of crisis over the long term.
According to the 2013 UBA Health Plan Survey of nearly 11,000 employers, 19.2% of all insurance plans offer some sort of wellness program. Health Risk Assessments (HRAs) remain the most popular offering with 81% of plans participating, 62.3% offer incentive awards (a 3.1% decrease), 61.3% offer a physical exam (a 1.1% decrease); the programs that saw the biggest increase were coaching at 56.2% (a 4.9% increase) and online wellness portals at 54.7% (a 4.7% increase).
The questions are whether comprehensive wellness programs are effective and how are results measured?
Whether or not a wellness program is effective depends on many factors, and most importantly, the organization’s goals. Typically, a wellness program is trying to increase employee engagement and productivity, while lowering long-term costs.
For all employers with wellness programs, the goal is to meet the needs of the employees to impact their overall health. In order to measure effectiveness, keep track of everything. Track participation in all events, onsite education, and challenges. Track cost per person, and most importantly, total population participation. Track progress and participation from year to year to see the overall impact of the program. Also, develop the wellness program around the medical claims trends. If available, use Health Risk Assessment (HRA) data and biometric data, as well.
How wellness programs impact productivity is difficult to measure, but not impossible. Return on investment of wellness related to worker productivity can be determined primarily with the utilization of an employee HRA that addresses the following four areas:
Implementing an HRA and having employees self-report how their health problems or specific conditions impact these four areas will provide employers with a method to determine the impact wellness has on productivity. Furthermore, the utilization of the HRA allows for employers to obtain aggregate reporting specific to productivity and participation.
Unfortunately, not all employers wish to implement an HRA campaign. Without having HRA data available, determining the impact wellness has on productivity is very difficult.
As previously mentioned, the key to finding value in developing a wellness program is ensuring the program has offerings and programs in which employees actually want to participate. Careful planning is essential. Employers must assess employee’s needs with an HRA or biometric data and also assess their wants with interest and incentive surveys. The question each employer should ask themselves is “What target am I trying to hit?” Then they should plan their program accordingly.
For further information about wellness trends, download a copy of the 2013 UBA Health Plan Survey Executive Summary http://bit.ly/PSEFrx.
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured mid-sized group plans.
By: Carol TaylorEmployee Benefit AdvisorD&S Agency, a UBA Partner Firm
Tacked into the Medicare provider payment fix bill was a repeal provision that removed the $2,000 single deductible maximum. The bill passed the U.S. House of Representatives in…
In order for the Internal Revenue Service (IRS) to verify that individuals and employers are meeting their shared responsibility obligations and that individuals who request premium tax credits are entitled to them, employers and issuers will be requir…
Counting employees under health care reform is not as easy as 1 – 2 – 3. The rules are quite complicated, and if not done correctly can have serious repercussions for your business. The final employer shared responsibility (“play or pay”) regulations have been issued and beginning in 2015, larger employers will need to either offer health coverage that meets the requirements of the Patient Protection and Affordable Care Act (PPACA) or pay penalties. Although the requirement is not effective until 2015, employers need to be gathering data and making decisions now.
Counting employees under health care reform is not as easy as 1 – 2 – 3. The rules are quite complicated, and if not done correctly can have serious repercussions for your business. The final employer shared responsibility (“play or pay”) regulations have been issued and beginning in 2015, larger employers will need to either offer health coverage that meets the requirements of the Patient Protection and Affordable Care Act (PPACA) or pay penalties. Although the requirement is not effective until 2015, employers need to be gathering data and making decisions now.
Want to know what is happening in Washington, D.C. as it relates to the now four-year-old Patient Protection and Affordable Care Act (PPACA)? While parts of the law have been implemented, major additional requirements are scheduled to take effect over …
Want to know what is happening in Washington, D.C. as it relates to the now four-year-old Patient Protection and Affordable Care Act (PPACA)? While parts of the law have been implemented, major additional requirements are scheduled to take effect over …
With every day that goes by, the nation’s employers move a step closer to having to make “play or pay” decisions. Many employers have less than a year to prepare for the arrival of this core provision of the Patient Protection and Affordable Care Act (PPACA). Their decisions are far from easy… the ensuing financial, legal, and competitive implications are profound… and the clock is ticking.
Some employers believe that the play or pay mandate will raise their costs and force them to make workforce cutbacks. As a result, they’re considering the “pay” option—i.e., eliminating their health care coverage altogether and paying the penalty on their full-time employees. Other employers are leaning toward “play,” which means they’ll offer employees medical coverage that meets the requirements of PPACA. While employers should look carefully at both options and do their best to calculate the outcomes of each, the actual solutions implemented by many likely will be creative combinations of approaches (making some reductions to benefits while enhancing others). After all, as with many other workforce-related decisions employers make, their main objective will be to remain financially competitive while still being able to attract and retain the employees they require.
When considering the financial implications of play or pay decisions, keep in mind the fact that PPACA actually calls for two potential penalties for large employers: One penalty for not offering “minimum essential” coverage, and the other penalty for offering coverage that’s considered inadequate because it isn’t “affordable” and/or doesn’t provide “minimum value.” Which employers are considered “large” is different for 2015 and later years. Under the law, an employer is considered “large” if it has 50 or more full-time or full-time equivalent (FTE) employees in its controlled group. However, employers with 50 to 99 full-time and full-time equivalent employees in their controlled group will not need to comply until 2016 if they meet certain requirements.
The minimum essential coverage penalty is calculated monthly at the rate of $166.67 for each full-time employee, less a set number of “free employees.” (Although the penalty is calculated monthly, it will be paid annually.) EXAMPLE: In 2016, Dave’s Donuts does not offer medical coverage to its employees. Dave has 60 full-time employees and 12 part-time employees. Two employees purchase coverage through an exchange. Dave’s Donuts will owe a penalty of $5000.10/month: 60 full-time employees, minus “30 free employees,” multiplied by $166.67 (part-time employees are not counted for purposes of this penalty).
In 2015, employers that owe penalties may subtract 80 “free employees.” For later years, that number will reduce to 30 “free employees.”
The penalty for not offering affordable minimum coverage is $250 per month ($3,000 per year) for each full-time employee who:
EXAMPLE: In 2016, Jones, Inc. has 55 full-time employees and eight part-time employees. Jones offers coverage that is minimum value, but which is not affordable for 10 of the full-time employees (nine of whom buy coverage through an exchange) and all of the part-time employees (who all buy coverage through an exchange). Seven of the nine full-time employees and six of the eight part-time employees who buy through an exchange qualify for a premium tax credit.
Jones, Inc. owes a penalty on each full-time employee who enrolls in an exchange plan and receives a premium tax credit, so the company owes $1,750 (seven regular full-time employees who receive a premium credit multiplied by $250; the part-time employees are not counted). The first 30 (or 80) employees do count under this “inadequate coverage” penalty. Also, if the “no offer” penalty would be less expensive than the “inadequate coverage” penalty, the employer would pay the “no offer” penalty. the “no offer” penalty.
For a closer look at these penalties and other key issues impacting play or pay decisions, download UBA’s white paper, “The Employer’s Guide to ‘Play or Pay’” http://bit.ly/1chiLEQ.
