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Looking back over 2015, there weren’t many new laws
enacted impacting employee benefits, though, there
were a few including:
 Surface Transportation and Veterans Health Care
Choice Improvement Act of 2015 (Public Law 114-
41; enacted July 31, 2015). This law provides that
veterans receiving coverage from TRICARE or the
Veterans Administration are not counted in
determining applicable large employer status under
the Affordable Care Act’s employer shared
responsibility provision. This provision applies
retroactively for months beginning January 1, 2014.
In addition, beginning January 1, 2016, veterans
receiving hospital care or medical services for
service-connected disability can participate and
contribute to health savings account (HSA).
 Protecting Affordable Coverage for Employees Act
(“PACE”)(Public Law 114-60; enacted October 7,
2015). This law allows a state to define small
employer for purposes of health insurance as an
employer employing between 1 and 50 employees.
This definition applies to all insurers, including those
in SHOPs (Small Business Health Options Programs).
Prior to enactment of PACE, a small employer would
have been defined as one employing between 1 and
100 employees, beginning January 1, 2016.
 Bipartisan Budget Act of 2015 (Public Law 114-74;
enacted November 2, 2015). This law repeals the
Affordable Care Act’s automatic enrollment provision.
This provision would have required employers
employing 200 or more employees to automatically
enroll new full-time equivalents into qualifying health
plans offered by the employer, plus automatically
continue enrollment of current employees.
December 11, 2015
In This Edition:
 OVERVIEW OF 2015
 QUICK REVIEW OF NEW
FEDERAL LAWS
 DOL ASSISTS STATES
ESTABLISHING SAVINGS
PROGRAMS
 PROPOSED CHANGES TO
ERISA’S DISABILITY CLAIMS
AND APPEAL PROCESS
 MORE IRS GUIDANCE ON
APPLICATION OF SAME-SEX
MARRIAGE TO BENEFIT PLANS
 2016 BENEFIT PLAN LIMITS
AND COST OF LIVING
ADJUSTMENTS
 YEAR-END REMINDERS
 ANNUAL NOTICE REMINDERS
page 1
December 11, 2015
continued from page 1
It was, nevertheless, a frenetic year for
HR and employee benefit departments
due in large part to regulatory activity. As
we sit on the precipice of 2016, it appears
that the same will be true next year.
In the welfare benefit plan arena, the
Equal Employment Opportunity
Commission issued two sets of proposed
regulations impacting wellness programs
this year – one relating to compliance with
the Americans with Disabilities Act,
and the second set relating to compliance
with the Genetic Information
Nondiscrimination Act. It is probable
that both sets of regulations will be
finalized sometime in 2016.
There was a plethora of guidance issued
this year relating to the Affordable Care
Act. For a recap of these matters, please
refer to the CBIZ Health Reform
Bulletins.
In the retirement plan arena, President
Obama, in his 2014 State of the Union
address, expressed an interest in
encouraging personal savings and directed
the Treasury Department to develop a
new Roth IRA-type plan option for
employers of any size who do not
currently offer a retirement plan. In this
“myRA” program, an employer would set
up a payroll direct deposit process for
employees to make contributions to their
myRA accounts if they choose to
participate. Also see the article, Updates
to myRA Program, below.
Coincidentally, several states have
initiated efforts to provide opportunities
for individuals to engage in personal
savings. One of the questions that have
arisen is how to reconcile these state
efforts with ERISA. As background, a
federal law, the Employee Retirement
Income Security Act (ERISA), was enacted
in 1974. The general premise is that
ERISA preempts state laws; thus, states
cannot mandate employers do anything as
it relates to employee benefits.
The Department of Labor (DOL), through
its enforcement arm, the Employee
Benefits Security Administration (EBSA) is
giving its effort to address the matter (see
the article, DOL Assists States Establishing
Savings Programs, below). Whether and
how these programs would work in
practice remains to be seen.
In addition, over the last several years,
EBSA has been looking at the evolution of
fiduciary responsibility particularly as it
relates to investment advice. As
background, under ERISA, any person,
including an individual, partnership, joint
venture, corporation, or the like, would be
deemed a plan fiduciary with respect to an
employee benefit plan to the extent that
the person:
 Exercises any discretionary authority
or control over plan management, or
exercises any authority or control
(whether or not it is discretionary)
over management or disposition of
plan assets;
 Renders investment advice for a fee or
other compensation, direct or indirect,
for any plan money or other plan
property; or
 Has any discretionary authority or
responsibility for plan administration.
The DOL first proposed regulations in
2010 governing investment advice by plan
fiduciaries. These regulations were
subsequently withdrawn and then re-
proposed in April, 2015. The comment
period for the re-proposed regulations
closed on September 24, 2015. However,
an effort is afoot in Congress to again
extend the comment period on these
regulations, potentially delaying the
issuance of them until after the November
2016 Presidential election. Stay tuned for
further developments on this front.
Following are summaries of a few
proposals that bear monitoring, as well as
some year-end reminders for plan
sponsors.
page 2
December 11, 2015
DOL ASSISTS STATES ESTABLISHING
SAVINGS PROGRAMS
Due to growing estimates that millions of
U.S. employees do not have access to
employer-based retirement savings,
several states have begun enacting laws
to assist them in establishing retirement
savings vehicles. To date, California,
Illinois and Oregon have enacted laws that
require private sector employers to offer,
or at least facilitate, retirement plans for
their workforce (see Are Employers
Required to Offer Retirement Plans? from
the Benefit Beat, January, 2015).
Specifically, these states have initiated
their programs as a payroll deduction
process to fund tax-favored individual
retirement plans. These programs include
an automatic enrollment feature wherein
the employer would continue to facilitate
payroll deduction amounts on behalf of
the employee unless the individual
affirmatively opts out of participation.
Several other states continue to explore
the possibility of requiring private sector
employers to implement similar saving
programs.
To this end, the DOL’s Employee Benefits
Security Administration released guidance
in the form of proposed rules and an
Interpretive Bulletin to assist states in
establishing these types of programs
without the programs becoming subject to
ERISA scrutiny.
The proposed rules provide a safe harbor
standard to assist in determining the
extent and involvement of employers in
these types of arrangements. In a
nutshell, as long as the employer’s
involvement is limited to payroll
functioning of withholding and forwarding
of the deductions to the savings vehicle,
and maintains limited or ministerial
functions, then the program would not be
deemed to be employer-sponsored for
ERISA purposes.
In addition, the DOL has sanctioned three
concepts to assist employers in
establishing ERISA retirement plans for
their employees. They are:
1. State-established marketplace wherein
private sector employers could select
an ERISA plan or non-ERISA plan in
which to participate;
2. State-based prototype plans wherein
the employer would sponsor a
prototype ERISA plan that would be
administered and managed by the
state or other designated third party;
or
3. Employers could participate in a state-
established multiple employer plans
(MEP) rather than establishing their
own separate plan. Such MEP would
be administered by the state or other
designated third party.
UPDATES TO MYRA PROGRAM
On the federal front, the Treasury
Department has added new features to
the myRA program. The myRA program
offers a way for employers to set up a
payroll direct deposit process for
employees to contribute to their myRA
account (see Benefit Beat article
referenced above for a summary of the
myRA program). Following its successful
pilot timeframe, there are three new ways
for employees to fund their myRA
accounts. They can fund the account
directly from their paycheck, from their
own checking or savings account, or direct
all or part of their federal tax refund to
the account when filing taxes.
More information about the myRa
program, including program materials that
could be shared with employees is
available on the Treasury Department’s
webpage: http://myra.gov/employers.
page 3
December 11, 2015
PROPOSED CHANGES TO ERISA’S
DISABILITY CLAIMS AND APPEAL
PROCESS
Plans subject to ERISA, both welfare and
retirement, must comply with rules
relating to claims for benefits and appeals
of such claims. The Affordable Care Act
(ACA) expanded these rules as it relates
to health plans.
On November 18, 2015, the DOL’s
Employee Benefits Security Administration
released proposed rules that are
intended to strengthen the existing ERISA
rules, as well as align the current
procedural protections and safeguards
with the ACA’s claims, appeals and
external review procedures.
Following are highlights of the proposed
rules (also see the related FAQs):
 Independence and impartiality:
avoiding conflicts of interest. Claims
and appeals must be adjudicated in
manner designed to ensure
independence and impartiality of the
individuals involved in making the
decision.
 Improvements to basic disclosure
requirements. Benefit denial notices
must contain a full discussion of why
the plan denied the claim and the
standards behind the decision.
 Right to review and respond to new
information before final decision.
Claimants would have access to their
entire claim file and would be allowed
to present evidence and testimony
during the review process. In
addition, claimants must be notified of
and have an opportunity to respond to
any new evidence, reasonably in
advance of an appeal decision. Any
final denial at the appeals stage
cannot be based on new or additional
rationales unless the claimant is given
notice and a fair opportunity to
respond.
 Deemed exhaustion of claims and
appeals processes. If plans fail to
adhere to all claims processing rules,
then the claimant would be deemed to
have exhausted the administrative
remedies available under the plan,
unless the violation was the result of a
minor error and other conditions are
met.
 Coverage rescissions: adverse benefit
determinations. Certain rescissions of
coverage must be treated as adverse
benefit determinations, thereby
triggering the plan's appeals
procedures.
 Notices must be written in a culturally
and linguistically appropriate manner.
This means that individuals residing in
a particular county where 10% or
more of its population are literate in a
non-English language must be
provided relevant communications in
the appropriate non-English language.
In addition, the plan would be required
to provide a customer assistance
process, such as a telephone hotline,
with oral language services available in
the non-English language.
The comment period on these proposals
closes on January 19, 2016. At this point,
these rules are only proposed and there is
no need to comply with the proposed
changes; however, it is worth monitoring
them in the event they become applicable.
MORE IRS GUIDANCE ON APPLICATION
OF SAME-SEX MARRIAGE TO BENEFIT
PLANS
In its on-going effort to provide guidance
on the treatment of spouses under
employee benefit plans, the IRS issued
Notice 2015-86 on December 9, 2015.
As result of the Supreme Court’s decisions
in United States v Windsor and Obergefell
v. Hodges, all legal marriages are treated
the same. Generally, for federal purposes,
including federal tax purposes, this has
been true since the Windsor decision on
June 26, 2013. There have been some
lingering questions, though, and this
guidance attempts to address them.
page 4
December 11, 2015
In a nutshell, an employer’s retirement
plan will retain qualified status even if it is
amended to recognize a same-sex spouse
as a spouse prior to June 26, 2013.
Further, a retirement plan can provide an
opportunity to an individual whose marital
status is recognized as a result of these
Court decisions, an opportunity for
enhanced benefits. For example, if the
individual was receiving a single annuity,
the plan can allow the individual to switch
to a joint and survivor annuity available to
spouses.
With regard to welfare benefit plans,
generally, these types of plans do not
define “spouse”. The guidance provides
that an IRC Section 125 cafeteria plan can
allow a mid-year status change due to
recognition of a marriage. If a Section
125 plan is amended to recognize same-
sex marriage, and particularly one that
was already in existence, a status change
event could be allowed as a result of a
benefit enhancement. It is common for a
cafeteria plan to include, as a status
change event, a change in coverage.
Before allowing this type of change,
however, an employer should review its
cafeteria plan, with particular emphasis on
status change events, to ensure proper
coordination of plan language. Generally,
it would be addressed under the title of
change in cost or coverage, or similar
title. If the plan does not include this type
of language, it could certainly be amended
to allow it.
 2016 BENEFIT PLAN LIMITS
In Revenue Procedure 2015-53, the
IRS released 2016 inflationary or cost of
living adjustments relating to several
types of benefits, as follows.
FLEXIBLE SPENDING ACCOUNT PLAN CAP
The amount that can be contributed to a
health flexible spending account (FSA)
plan through voluntary salary reductions
in 2016 is unchanged from 2015 and
remains at $2,550.
SMALL BUSINESS TAX CREDIT (SBTC)
Small businesses and tax-exempt
employers who provide health care
coverage to their employees under a
qualified health care arrangement are
entitled to a tax credit, as established by
the Affordable Care Act.
To be eligible for the small business tax
credit, the employer must employ fewer
than 25 full-time equivalent employees
whose average annual wages are less
than $50,800 (indexed for 2015). The tax
credit phases out for eligible small
employers when the number of its full-
time employees (FTEs) exceeds 10; or,
when the average annual wages for the
FTEs exceeds $25,900 in the 2016 tax
year (the phase-out wage limit for 2015
was $25,800).
As a reminder, only qualified health plan
coverage purchased through a SHOP
marketplace is available for the tax credit,
and only for a 2-consecutive year period.
QUALIFIED TRANSPORTATION FRINGE
BENEFITS
With regard to transportation expenses
reimbursed by an employer and
excludable from the employee’s income
under a qualified transportation program,
there is a slight increase in the amount for
qualified parking in 2016:
2015 2016
COMMUTER HIGHWAY VEHICLE
(VAN POOLING) AND
ANY TRANSIT PASS
$130 $130
QUALIFIED PARKING $250 $255
As a reminder, employees who use their
bicycles for traveling between home and
their place of employment are entitled to
receive a reimbursement of up to $20 per
month ($240 annually) for qualified
bicycle expenses. This limit is not indexed
nor tied to a cost of living adjustment.
page 5
December 11, 2015
QUALIFIED ADOPTION ASSISTANCE
REIMBURSEMENT PROGRAM (IRC §137)
An employer-provided adoption
assistance program that meets the
qualifications of IRC §137, allows
participants to recover expenses relating
to adoption, such as reasonable adoption
fees, court costs, attorney’s fees and
traveling expenses. Below are the
exclusion limits and adjusted gross
income (AGI) phase-out limits for 2015
and 2016:
2015 2016
EXCLUSION
LIMIT
$13,400 $13,460
AGI PHASE-
OUT LIMITS
BETWEEN
$201,010 AND
$241,040
BETWEEN
$201,920 AND
$241,920
HEALTH SAVINGS ACCOUNTS
Please note that the 2016 annual limits
applicable to health savings accounts were
released earlier this year (see Health
Savings Accounts – 2016 Cost of Living
Adjustments, Benefit Beat, 5/12/15).
ARCHER MEDICAL SAVINGS ACCOUNTS
The Archer MSA pilot project ended on
December 31, 2007; therefore, no new
MSAs could be established after that date.
For existing MSAs, the annual deductible
limits of a high deductible health plan
used in conjunction with an Archer
medical savings account for 2016 are
slightly increased:
2016
SINGLE FAMILY
HDHP ANNUAL
DEDUCTIBLE
BETWEEN
$2,250 AND
$3,350
BETWEEN
$4,450 AND
$6,700
OUT-OF-POCKET
EXPENSES
$4,450 $8,150
LONG-TERM CARE PREMIUMS
The IRS limitations relating to eligible
long-term care premiums includible as
medical care, as defined by IRC §213(d)
are:
AGE AT END
OF TAX YEAR
2016 PREMIUM
LIMIT
<40 $390
>40 BUT <50 $730
>50 BUT <60 $1,460
>60 BUT <70 $3,900
>70 $4,870
PREMIUM TAX CREDIT FOR COVERAGE UNDER
A QUALIFIED HEALTH PLAN
Individuals who buy coverage through the
marketplace and meet certain income
criteria may be eligible for an advance
credit payment wherein a portion of the
premium is made directly to the insurer to
cover the cost of coverage. The amount
of an individual’s premium tax credit is
reduced by the amount of any advance
credit payments made during the year. If
the advance credit payment for a taxable
year exceeds the premium tax credit limit,
the individual would owe the excess as
additional tax, subject to certain
inflationary limits. For tax years
beginning in 2016, the limitation on tax
imposed for excess advance credit
payments is determined using the
following table:
HOUSEHOLD
INCOME
(AS PERCENT
OF POVERTY
LINE)
LIMITATION
AMOUNT FOR
UNMARRIED
INDIVIDUALS
(OTHER THAN
SURVIVING SPOUSE
AND HEAD OF
HOUSEHOLD)
LIMITATION
AMOUNT FOR ALL
OTHER
TAXPAYERS
UNDER 200% $300 $600
BETWEEN
200% AND
300%
$750 $1,500
BETWEEN
300% AND
400%
$1,275 $2,550
page 6
December 11, 2015
2016 PENSION AND RETIREMENT PLAN
LIMITS
The 2016 plan limits, applicable to defined
benefit and defined contribution plans,
have been issued by the IRS (highlights
below). Note, however, these pension
limits, as well as the Social Security wage
base, will remain unchanged in 2016 due
to a flat cost of living index.
Sources:
 IRS News Release
 IRS COLA Table ( 2014-2016 limits)
2016 SOCIAL SECURITY COST-OF-
LIVING ADJUSTMENT
The Social Security Administration (SSA)
announced that there will be no cost of
living adjustments for 2016. Thus, the
Social Security wage base in 2016 will
remain unchanged from the 2015 wage
level of $118,500.
The Medicare tax is generally assessed on
all wages. The combined tax rate remains
at 7.65% - the Social Security portion is
6.2% on wages up to the applicable
maximum taxable amount; the Medicare
portion is 1.45% on all wages. Additional
adjustments are included in the SSA’s
Fact Sheet: 2016 Social Security Cost-
of-Living Adjustments.
2016 MEDICARE PREMIUMS AND
DEDUCTIBLES
The Centers for Medicare & Medicaid
Services released the 2016 premiums and
deductibles for the Medicare Part A and
Part B programs.
Medicare Part A Premium and
Deductible
 Generally, there is no monthly Part A
premium for those with 40+ quarters
of Medicare-covered employment.
Individuals who buy Part A will pay up
to $411 each month in 2016.
 Part A deductibles in 2016 will be
$1,288 for first 60 days of inpatient
care; an additional $322 co-insurance
per day for days 61 through 90, and
additional $644 per day beyond the
90th day.
Medicare Part B Premium and
Deductible
 The annual deductible for Part B
beneficiaries will increase from $147 to
$166 in 2016.
 With regard to Part B premium,
because there was no Social Security
cost of living increase for 2016, the
monthly premium for most individuals
with Medicare Part B will remain the
same as last year ($104.90). The
amount of monthly premium is
adjusted based on income – see chart
below:
2015 2016
DEFINED BENEFIT PLAN ANNUAL
LIMIT
$210,000 $210,000
DEFINED CONTRIBUTION PLAN
ANNUAL LIMIT
$53,000 $53,000
ELECTIVE DEFERRAL LIMIT FOR
PURPOSES OF CASH OR DEFERRED
ARRANGEMENTS (401(K) PLANS)
AND TAX-SHELTERED ANNUITIES
(403(B) PLANS)
$18,000 $18,000
MAXIMUM DEFERRAL LIMIT FOR
457 PLANS
$18,000 $18,000
>AGE 50 CATCH-UP
CONTRIBUTION LIMIT TO
401(K), 403(B) OR 457(B)
PLANS
$6,000 $6,000
MAXIMUM DEFERRAL LIMIT FOR
SIMPLE PLANS
$12,500 $12,500
>AGE 50 CATCH-UP
CONTRIBUTION LIMIT TO
SIMPLE PLANS
$3,000 $3,000
MINIMUM COMPENSATION
CONSIDERED IN DETERMINING
ELIGIBILITY FOR A SEP
$600 $600
THRESHOLD FOR HIGHLY
COMPENSATED EMPLOYEE (HCE)
$120,000 $120,000
KEY EMPLOYEE COMPENSATION
LIMIT FOR TOP HEAVY PLAN
PURPOSES
$170,000 $170,000
ANNUAL COMPENSATION LIMIT $265,000 $265,000
page 7
December 11, 2015
Beneficiaries
who file an
individual tax
return with
income:
Beneficiaries
who file a
joint tax
return with
income:
Income-
related
monthly
adjustment
amount
Total
monthly
premium
amount
≤ $85,000 ≤ $170,000 $0.00 $121.80
>$85,000
and
≤ $107,000
> $170,000
and
≤ $214,000 48.70 170.50
> $107,000
and
≤ $160,000
> $214,000
and
≤ $320,000 121.80 243.60
> $160,000
and
≤ $214,000
> $320,000
and
≤ $428,000 194.90 316.70
> $214,000 > $428,000 268.00 389.80
Part B premiums for individuals who are
married, live with their spouse at any time
during the taxable year, and file a
separate return are:
Beneficiaries who are
married and lived with
their spouse at any time
during the year, but file a
separate tax return from
their spouse:
Income-
related
monthly
adjustment
amount
Total
monthly
premium
amount
≤ $85,000 $0.00 $121.80
> $85,000 and
≤ $129,000 194.90 316.70
> $129,000 268.00 389.80
Medicare Parts C and D monthly premiums
vary by plan.
Additional information about Medicare
premium and deductibles is available from
Medicare’s 2015 & 2016 Costs at a
Glance and CMS press release.
 YEAR-END REMINDERS
COBRA
If you employed 20 or more employees on
at least 50 percent of the business days in
2015, and if you sponsor a group health
plan, COBRA will be applicable to the plan
in 2016, unless another exception applies.
ACA’S EMPLOYER SHARED RESPONSIBILITY:
REQUIRED REPORTING AND DISCLOSURE
The Affordable Care Act (ACA) imposes
two new Internal Revenue Code sections.
One requires reporting of minimum
essential coverage (MEC); the other
requires employers subject to the
employer shared responsibility provisions
to report on offers of coverage. This
reporting is required beginning January 1,
2015, with the first reports due in 2016.
The forms for both of these reporting
requirements are the Form 1094
transmittal and Form 1095 benefit
statement. IRC Section 6055 reporting is
accomplished on the B series of the form;
the employer shared responsibility
reporting is accomplished on the C series.
A self-funded employer subject to shared
responsibility can satisfy both its IRC
Sections 6055 and 6056 reporting
obligations by completing all parts of the
Form 1095-C.
Deadlines for Filing and Distributing
Forms 1094 and 1095
 File Forms 1094 and 1095 with
IRS no later than February 28th
of
each year (by March 31st
of each year
if filed electronically). Note, the due
date for 2015 forms is February 29,
2016 (or March 31, 2016, if filing
electronically)
 Furnish Form 1095 to Individuals
Individuals listed in relevant Forms
1094 and 1095 must be furnished
copy of the relevant Form 1095
annually by January 31st
of each year
(or, by next business day if January
31st
falls on Saturday or Sunday).
FORM W-2 REMINDERS
 Aggregate Cost of Health Coverage
Pursuant to the Affordable Care Act,
the Form W-2 must include the
aggregate cost of health coverage.
For details about this mandatory
reporting, see these CBIZ Health
Reform Bulletins, Reminder: Fast
Approaching Form W-2 Reporting
Requirement and Additional IRS
page 8
December 11, 2015
Guidance on W-2 Reporting
Requirement. The aggregate cost
information is to be reported in Box
12, using Code DD. As a reminder,
employers exempt from electronic W-2
filing requirement, i.e., file fewer than
250 Form W-2s per year, remain
exempt from reporting the aggregate
cost of health coverage on the Form
W-2 until future IRS guidance is
issued.
 Health Savings Accounts. Employer
contributions (including amounts
employees elect to contribute via an
IRC §125 cafeteria plan) to an HSA are
reported in Box 12 - Code W.
 Disability Income. Any employee
receiving sick pay benefits from a third
party payer, such as an insurance
company, must be provided a Form W-
2 reflecting these amounts. The
employer is responsible for providing
the Form W-2 if the third party payer
has notified the employer accordingly.
The third party payer will provide the
employer with the relevant information
to be included on the Form W-2. This
information must be given to the
employee by January 31, 2016, for
benefits paid in 2015.
 Dependent Care Assistance
Programs. Amounts reimbursed
through a dependent care assistance
program and amounts in excess of the
maximum $5,000 exclusion must be
reported in Box 10 of the Form W-2.
Amounts over the $5,000 exclusion
amounts must be included in Boxes 1,
3 and 5.
 Group Term Life Insurance. The
cost of group term life insurance over
$50,000 (Table I rates only, as below)
is reported in Boxes 1, 3 and 5. Also,
show the amount in Box 12 - Code C.
TABLE I – UNIFORM PREMIUMS FOR $1,000 OF
GROUP TERM LIFE INSURANCE PROTECTION
5-year
Age Bracket
Cost per $1,000 of
Protection for one
Month
Under 25 $0.05
25 to 29 .06
30 to 34 .08
35 to 39 .09
40 to 44 .10
45 to 49 .15
50 to 54 .23
55 to 59 .43
60 to 64 .66
65 to 69 1.27
70 and above 2.06
 Additional Medicare Tax
Withholding on High Earners. The
Affordable Care Act imposes a 0.9%
increase in the individual’s Medicare
tax rate, applicable on earnings in
excess of $200,000 in a calendar year.
On the Form W-2, the employer would
enter the total employee Medicare tax
(including any Additional Medicare
Tax) withheld on Medicare wages and
tips in Box 6 (“Medicare tax
withheld”). The employer is also
required to report any individual’s
wages paid during the quarter
exceeding the $200,000 withholding
threshold for the year, as well as the
withholding liability for Additional
Medicare Tax on those wages on the
Form 941 series.
FORM M-1 FOR MEWAS
If you sponsored a multiple employer
welfare arrangement (MEWA) in 2015,
make certain that you file the Form M-1
annual report by March 1, 2016. As a
reminder, all welfare benefit plans
required to file a Form M-1 are required to
file the Form 5500 regardless of the plan
size or type of funding. The Form M-1 can
only be submitted electronically through
the DOL’s Online Filing System
(http://www.askebsa.dol.gov/mewa/).
page 9
December 11, 2015
MEDICARE PART D DISCLOSURE
NOTICE TO CMS
The annual report, Creditable Coverage
Disclosure Form, must be submitted to
CMS describing whether the prescription
drug coverage is creditable or not
creditable. This filing must be
accomplished electronically, and is due
within 60 days of the commencement of
the plan year. For details about this
notice, see CMS guidance and
instructions.
 ANNUAL NOTICE REMINDERS
Following are certain plan sponsor
notification obligations that must be
provided on an annual basis to plan
participants.
 Summary Annual Report
Plans subject to Form 5500 reporting
are required to provide a Summary
Annual Report with specific information
derived from Form 5500. The SAR is
required to be provided to plan
participants within 9 months after
close of plan year.
 Annual Women’s Health and
Cancer Rights Act (WHCRA) Notice
This notice describes plan coverage of
mastectomy, reconstructive surgery,
prosthesis and treatment for physical
complications. It can be provided as a
separate written notification, or
included in a plan’s annual enrollment
materials.
 Medicaid/CHIP Premium
Assistance Notice
This notice describes availability of
premium assistance from Medicaid or
CHIP toward employer-sponsored
coverage. It must be provided to all
employees who reside in states
offering premium assistance. The
notice can be distributed as a separate
written document, or included in a
plan’s annual enrollment materials.
 Medicare Part D - Creditable
Coverage Disclosure Notice
This notice must be provided prior to
Medicare’s annual enrollment period
(October 15th
through Dec 7th
). The
notice must be provided to all
Medicare-eligible individuals, including
employees, former employees, and
Medicare-eligible dependents, who are
covered by the plan, or who become
eligible to enroll in the plan.
 401(K) PLAN NOTICES
Participants in 401(k) plans must be
furnished certain information relating
to the plan, including annual and
quarterly fee disclosures. A
comparative investment chart must be
included with the annual participant
disclosure.
In addition, 401(k) plans are obligated
to provide an annual notice of
automatic enrollment and qualified
default investment alternative (QDIA)
notice, if applicable to the plan.
ABOUT THE AUTHOR: Karen R. McLeese is Vice
President of Employee Benefit Regulatory Affairs
for CBIZ Benefits & Insurance Services, Inc., a
division of CBIZ, Inc. She serves as in-house
counsel, with particular emphasis on monitoring
and interpreting state and federal employee
benefits law. Ms. McLeese is based in the CBIZ
Kansas City office.
The information contained in this At Issue is not
intended to be legal, accounting, or other
professional advice, nor are these comments
directed to specific situations. This information is
provided as general guidance and may be affected
by changes in law or regulation. This information is
not intended to replace or substitute for accounting
or other professional advice. You must consult your
own attorney or tax advisor for assistance in specific
situations. This information is provided as-is, with no
warranties of any kind. CBIZ shall not be liable for
any damages whatsoever in connection with its use
and assumes no obligation to inform the reader of
any changes in laws or other factors that could affect
the information contained herein.
page 10

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At Issue Dec 2015

  • 1. Looking back over 2015, there weren’t many new laws enacted impacting employee benefits, though, there were a few including:  Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 (Public Law 114- 41; enacted July 31, 2015). This law provides that veterans receiving coverage from TRICARE or the Veterans Administration are not counted in determining applicable large employer status under the Affordable Care Act’s employer shared responsibility provision. This provision applies retroactively for months beginning January 1, 2014. In addition, beginning January 1, 2016, veterans receiving hospital care or medical services for service-connected disability can participate and contribute to health savings account (HSA).  Protecting Affordable Coverage for Employees Act (“PACE”)(Public Law 114-60; enacted October 7, 2015). This law allows a state to define small employer for purposes of health insurance as an employer employing between 1 and 50 employees. This definition applies to all insurers, including those in SHOPs (Small Business Health Options Programs). Prior to enactment of PACE, a small employer would have been defined as one employing between 1 and 100 employees, beginning January 1, 2016.  Bipartisan Budget Act of 2015 (Public Law 114-74; enacted November 2, 2015). This law repeals the Affordable Care Act’s automatic enrollment provision. This provision would have required employers employing 200 or more employees to automatically enroll new full-time equivalents into qualifying health plans offered by the employer, plus automatically continue enrollment of current employees. December 11, 2015 In This Edition:  OVERVIEW OF 2015  QUICK REVIEW OF NEW FEDERAL LAWS  DOL ASSISTS STATES ESTABLISHING SAVINGS PROGRAMS  PROPOSED CHANGES TO ERISA’S DISABILITY CLAIMS AND APPEAL PROCESS  MORE IRS GUIDANCE ON APPLICATION OF SAME-SEX MARRIAGE TO BENEFIT PLANS  2016 BENEFIT PLAN LIMITS AND COST OF LIVING ADJUSTMENTS  YEAR-END REMINDERS  ANNUAL NOTICE REMINDERS page 1
  • 2. December 11, 2015 continued from page 1 It was, nevertheless, a frenetic year for HR and employee benefit departments due in large part to regulatory activity. As we sit on the precipice of 2016, it appears that the same will be true next year. In the welfare benefit plan arena, the Equal Employment Opportunity Commission issued two sets of proposed regulations impacting wellness programs this year – one relating to compliance with the Americans with Disabilities Act, and the second set relating to compliance with the Genetic Information Nondiscrimination Act. It is probable that both sets of regulations will be finalized sometime in 2016. There was a plethora of guidance issued this year relating to the Affordable Care Act. For a recap of these matters, please refer to the CBIZ Health Reform Bulletins. In the retirement plan arena, President Obama, in his 2014 State of the Union address, expressed an interest in encouraging personal savings and directed the Treasury Department to develop a new Roth IRA-type plan option for employers of any size who do not currently offer a retirement plan. In this “myRA” program, an employer would set up a payroll direct deposit process for employees to make contributions to their myRA accounts if they choose to participate. Also see the article, Updates to myRA Program, below. Coincidentally, several states have initiated efforts to provide opportunities for individuals to engage in personal savings. One of the questions that have arisen is how to reconcile these state efforts with ERISA. As background, a federal law, the Employee Retirement Income Security Act (ERISA), was enacted in 1974. The general premise is that ERISA preempts state laws; thus, states cannot mandate employers do anything as it relates to employee benefits. The Department of Labor (DOL), through its enforcement arm, the Employee Benefits Security Administration (EBSA) is giving its effort to address the matter (see the article, DOL Assists States Establishing Savings Programs, below). Whether and how these programs would work in practice remains to be seen. In addition, over the last several years, EBSA has been looking at the evolution of fiduciary responsibility particularly as it relates to investment advice. As background, under ERISA, any person, including an individual, partnership, joint venture, corporation, or the like, would be deemed a plan fiduciary with respect to an employee benefit plan to the extent that the person:  Exercises any discretionary authority or control over plan management, or exercises any authority or control (whether or not it is discretionary) over management or disposition of plan assets;  Renders investment advice for a fee or other compensation, direct or indirect, for any plan money or other plan property; or  Has any discretionary authority or responsibility for plan administration. The DOL first proposed regulations in 2010 governing investment advice by plan fiduciaries. These regulations were subsequently withdrawn and then re- proposed in April, 2015. The comment period for the re-proposed regulations closed on September 24, 2015. However, an effort is afoot in Congress to again extend the comment period on these regulations, potentially delaying the issuance of them until after the November 2016 Presidential election. Stay tuned for further developments on this front. Following are summaries of a few proposals that bear monitoring, as well as some year-end reminders for plan sponsors. page 2
  • 3. December 11, 2015 DOL ASSISTS STATES ESTABLISHING SAVINGS PROGRAMS Due to growing estimates that millions of U.S. employees do not have access to employer-based retirement savings, several states have begun enacting laws to assist them in establishing retirement savings vehicles. To date, California, Illinois and Oregon have enacted laws that require private sector employers to offer, or at least facilitate, retirement plans for their workforce (see Are Employers Required to Offer Retirement Plans? from the Benefit Beat, January, 2015). Specifically, these states have initiated their programs as a payroll deduction process to fund tax-favored individual retirement plans. These programs include an automatic enrollment feature wherein the employer would continue to facilitate payroll deduction amounts on behalf of the employee unless the individual affirmatively opts out of participation. Several other states continue to explore the possibility of requiring private sector employers to implement similar saving programs. To this end, the DOL’s Employee Benefits Security Administration released guidance in the form of proposed rules and an Interpretive Bulletin to assist states in establishing these types of programs without the programs becoming subject to ERISA scrutiny. The proposed rules provide a safe harbor standard to assist in determining the extent and involvement of employers in these types of arrangements. In a nutshell, as long as the employer’s involvement is limited to payroll functioning of withholding and forwarding of the deductions to the savings vehicle, and maintains limited or ministerial functions, then the program would not be deemed to be employer-sponsored for ERISA purposes. In addition, the DOL has sanctioned three concepts to assist employers in establishing ERISA retirement plans for their employees. They are: 1. State-established marketplace wherein private sector employers could select an ERISA plan or non-ERISA plan in which to participate; 2. State-based prototype plans wherein the employer would sponsor a prototype ERISA plan that would be administered and managed by the state or other designated third party; or 3. Employers could participate in a state- established multiple employer plans (MEP) rather than establishing their own separate plan. Such MEP would be administered by the state or other designated third party. UPDATES TO MYRA PROGRAM On the federal front, the Treasury Department has added new features to the myRA program. The myRA program offers a way for employers to set up a payroll direct deposit process for employees to contribute to their myRA account (see Benefit Beat article referenced above for a summary of the myRA program). Following its successful pilot timeframe, there are three new ways for employees to fund their myRA accounts. They can fund the account directly from their paycheck, from their own checking or savings account, or direct all or part of their federal tax refund to the account when filing taxes. More information about the myRa program, including program materials that could be shared with employees is available on the Treasury Department’s webpage: http://myra.gov/employers. page 3
  • 4. December 11, 2015 PROPOSED CHANGES TO ERISA’S DISABILITY CLAIMS AND APPEAL PROCESS Plans subject to ERISA, both welfare and retirement, must comply with rules relating to claims for benefits and appeals of such claims. The Affordable Care Act (ACA) expanded these rules as it relates to health plans. On November 18, 2015, the DOL’s Employee Benefits Security Administration released proposed rules that are intended to strengthen the existing ERISA rules, as well as align the current procedural protections and safeguards with the ACA’s claims, appeals and external review procedures. Following are highlights of the proposed rules (also see the related FAQs):  Independence and impartiality: avoiding conflicts of interest. Claims and appeals must be adjudicated in manner designed to ensure independence and impartiality of the individuals involved in making the decision.  Improvements to basic disclosure requirements. Benefit denial notices must contain a full discussion of why the plan denied the claim and the standards behind the decision.  Right to review and respond to new information before final decision. Claimants would have access to their entire claim file and would be allowed to present evidence and testimony during the review process. In addition, claimants must be notified of and have an opportunity to respond to any new evidence, reasonably in advance of an appeal decision. Any final denial at the appeals stage cannot be based on new or additional rationales unless the claimant is given notice and a fair opportunity to respond.  Deemed exhaustion of claims and appeals processes. If plans fail to adhere to all claims processing rules, then the claimant would be deemed to have exhausted the administrative remedies available under the plan, unless the violation was the result of a minor error and other conditions are met.  Coverage rescissions: adverse benefit determinations. Certain rescissions of coverage must be treated as adverse benefit determinations, thereby triggering the plan's appeals procedures.  Notices must be written in a culturally and linguistically appropriate manner. This means that individuals residing in a particular county where 10% or more of its population are literate in a non-English language must be provided relevant communications in the appropriate non-English language. In addition, the plan would be required to provide a customer assistance process, such as a telephone hotline, with oral language services available in the non-English language. The comment period on these proposals closes on January 19, 2016. At this point, these rules are only proposed and there is no need to comply with the proposed changes; however, it is worth monitoring them in the event they become applicable. MORE IRS GUIDANCE ON APPLICATION OF SAME-SEX MARRIAGE TO BENEFIT PLANS In its on-going effort to provide guidance on the treatment of spouses under employee benefit plans, the IRS issued Notice 2015-86 on December 9, 2015. As result of the Supreme Court’s decisions in United States v Windsor and Obergefell v. Hodges, all legal marriages are treated the same. Generally, for federal purposes, including federal tax purposes, this has been true since the Windsor decision on June 26, 2013. There have been some lingering questions, though, and this guidance attempts to address them. page 4
  • 5. December 11, 2015 In a nutshell, an employer’s retirement plan will retain qualified status even if it is amended to recognize a same-sex spouse as a spouse prior to June 26, 2013. Further, a retirement plan can provide an opportunity to an individual whose marital status is recognized as a result of these Court decisions, an opportunity for enhanced benefits. For example, if the individual was receiving a single annuity, the plan can allow the individual to switch to a joint and survivor annuity available to spouses. With regard to welfare benefit plans, generally, these types of plans do not define “spouse”. The guidance provides that an IRC Section 125 cafeteria plan can allow a mid-year status change due to recognition of a marriage. If a Section 125 plan is amended to recognize same- sex marriage, and particularly one that was already in existence, a status change event could be allowed as a result of a benefit enhancement. It is common for a cafeteria plan to include, as a status change event, a change in coverage. Before allowing this type of change, however, an employer should review its cafeteria plan, with particular emphasis on status change events, to ensure proper coordination of plan language. Generally, it would be addressed under the title of change in cost or coverage, or similar title. If the plan does not include this type of language, it could certainly be amended to allow it.  2016 BENEFIT PLAN LIMITS In Revenue Procedure 2015-53, the IRS released 2016 inflationary or cost of living adjustments relating to several types of benefits, as follows. FLEXIBLE SPENDING ACCOUNT PLAN CAP The amount that can be contributed to a health flexible spending account (FSA) plan through voluntary salary reductions in 2016 is unchanged from 2015 and remains at $2,550. SMALL BUSINESS TAX CREDIT (SBTC) Small businesses and tax-exempt employers who provide health care coverage to their employees under a qualified health care arrangement are entitled to a tax credit, as established by the Affordable Care Act. To be eligible for the small business tax credit, the employer must employ fewer than 25 full-time equivalent employees whose average annual wages are less than $50,800 (indexed for 2015). The tax credit phases out for eligible small employers when the number of its full- time employees (FTEs) exceeds 10; or, when the average annual wages for the FTEs exceeds $25,900 in the 2016 tax year (the phase-out wage limit for 2015 was $25,800). As a reminder, only qualified health plan coverage purchased through a SHOP marketplace is available for the tax credit, and only for a 2-consecutive year period. QUALIFIED TRANSPORTATION FRINGE BENEFITS With regard to transportation expenses reimbursed by an employer and excludable from the employee’s income under a qualified transportation program, there is a slight increase in the amount for qualified parking in 2016: 2015 2016 COMMUTER HIGHWAY VEHICLE (VAN POOLING) AND ANY TRANSIT PASS $130 $130 QUALIFIED PARKING $250 $255 As a reminder, employees who use their bicycles for traveling between home and their place of employment are entitled to receive a reimbursement of up to $20 per month ($240 annually) for qualified bicycle expenses. This limit is not indexed nor tied to a cost of living adjustment. page 5
  • 6. December 11, 2015 QUALIFIED ADOPTION ASSISTANCE REIMBURSEMENT PROGRAM (IRC §137) An employer-provided adoption assistance program that meets the qualifications of IRC §137, allows participants to recover expenses relating to adoption, such as reasonable adoption fees, court costs, attorney’s fees and traveling expenses. Below are the exclusion limits and adjusted gross income (AGI) phase-out limits for 2015 and 2016: 2015 2016 EXCLUSION LIMIT $13,400 $13,460 AGI PHASE- OUT LIMITS BETWEEN $201,010 AND $241,040 BETWEEN $201,920 AND $241,920 HEALTH SAVINGS ACCOUNTS Please note that the 2016 annual limits applicable to health savings accounts were released earlier this year (see Health Savings Accounts – 2016 Cost of Living Adjustments, Benefit Beat, 5/12/15). ARCHER MEDICAL SAVINGS ACCOUNTS The Archer MSA pilot project ended on December 31, 2007; therefore, no new MSAs could be established after that date. For existing MSAs, the annual deductible limits of a high deductible health plan used in conjunction with an Archer medical savings account for 2016 are slightly increased: 2016 SINGLE FAMILY HDHP ANNUAL DEDUCTIBLE BETWEEN $2,250 AND $3,350 BETWEEN $4,450 AND $6,700 OUT-OF-POCKET EXPENSES $4,450 $8,150 LONG-TERM CARE PREMIUMS The IRS limitations relating to eligible long-term care premiums includible as medical care, as defined by IRC §213(d) are: AGE AT END OF TAX YEAR 2016 PREMIUM LIMIT <40 $390 >40 BUT <50 $730 >50 BUT <60 $1,460 >60 BUT <70 $3,900 >70 $4,870 PREMIUM TAX CREDIT FOR COVERAGE UNDER A QUALIFIED HEALTH PLAN Individuals who buy coverage through the marketplace and meet certain income criteria may be eligible for an advance credit payment wherein a portion of the premium is made directly to the insurer to cover the cost of coverage. The amount of an individual’s premium tax credit is reduced by the amount of any advance credit payments made during the year. If the advance credit payment for a taxable year exceeds the premium tax credit limit, the individual would owe the excess as additional tax, subject to certain inflationary limits. For tax years beginning in 2016, the limitation on tax imposed for excess advance credit payments is determined using the following table: HOUSEHOLD INCOME (AS PERCENT OF POVERTY LINE) LIMITATION AMOUNT FOR UNMARRIED INDIVIDUALS (OTHER THAN SURVIVING SPOUSE AND HEAD OF HOUSEHOLD) LIMITATION AMOUNT FOR ALL OTHER TAXPAYERS UNDER 200% $300 $600 BETWEEN 200% AND 300% $750 $1,500 BETWEEN 300% AND 400% $1,275 $2,550 page 6
  • 7. December 11, 2015 2016 PENSION AND RETIREMENT PLAN LIMITS The 2016 plan limits, applicable to defined benefit and defined contribution plans, have been issued by the IRS (highlights below). Note, however, these pension limits, as well as the Social Security wage base, will remain unchanged in 2016 due to a flat cost of living index. Sources:  IRS News Release  IRS COLA Table ( 2014-2016 limits) 2016 SOCIAL SECURITY COST-OF- LIVING ADJUSTMENT The Social Security Administration (SSA) announced that there will be no cost of living adjustments for 2016. Thus, the Social Security wage base in 2016 will remain unchanged from the 2015 wage level of $118,500. The Medicare tax is generally assessed on all wages. The combined tax rate remains at 7.65% - the Social Security portion is 6.2% on wages up to the applicable maximum taxable amount; the Medicare portion is 1.45% on all wages. Additional adjustments are included in the SSA’s Fact Sheet: 2016 Social Security Cost- of-Living Adjustments. 2016 MEDICARE PREMIUMS AND DEDUCTIBLES The Centers for Medicare & Medicaid Services released the 2016 premiums and deductibles for the Medicare Part A and Part B programs. Medicare Part A Premium and Deductible  Generally, there is no monthly Part A premium for those with 40+ quarters of Medicare-covered employment. Individuals who buy Part A will pay up to $411 each month in 2016.  Part A deductibles in 2016 will be $1,288 for first 60 days of inpatient care; an additional $322 co-insurance per day for days 61 through 90, and additional $644 per day beyond the 90th day. Medicare Part B Premium and Deductible  The annual deductible for Part B beneficiaries will increase from $147 to $166 in 2016.  With regard to Part B premium, because there was no Social Security cost of living increase for 2016, the monthly premium for most individuals with Medicare Part B will remain the same as last year ($104.90). The amount of monthly premium is adjusted based on income – see chart below: 2015 2016 DEFINED BENEFIT PLAN ANNUAL LIMIT $210,000 $210,000 DEFINED CONTRIBUTION PLAN ANNUAL LIMIT $53,000 $53,000 ELECTIVE DEFERRAL LIMIT FOR PURPOSES OF CASH OR DEFERRED ARRANGEMENTS (401(K) PLANS) AND TAX-SHELTERED ANNUITIES (403(B) PLANS) $18,000 $18,000 MAXIMUM DEFERRAL LIMIT FOR 457 PLANS $18,000 $18,000 >AGE 50 CATCH-UP CONTRIBUTION LIMIT TO 401(K), 403(B) OR 457(B) PLANS $6,000 $6,000 MAXIMUM DEFERRAL LIMIT FOR SIMPLE PLANS $12,500 $12,500 >AGE 50 CATCH-UP CONTRIBUTION LIMIT TO SIMPLE PLANS $3,000 $3,000 MINIMUM COMPENSATION CONSIDERED IN DETERMINING ELIGIBILITY FOR A SEP $600 $600 THRESHOLD FOR HIGHLY COMPENSATED EMPLOYEE (HCE) $120,000 $120,000 KEY EMPLOYEE COMPENSATION LIMIT FOR TOP HEAVY PLAN PURPOSES $170,000 $170,000 ANNUAL COMPENSATION LIMIT $265,000 $265,000 page 7
  • 8. December 11, 2015 Beneficiaries who file an individual tax return with income: Beneficiaries who file a joint tax return with income: Income- related monthly adjustment amount Total monthly premium amount ≤ $85,000 ≤ $170,000 $0.00 $121.80 >$85,000 and ≤ $107,000 > $170,000 and ≤ $214,000 48.70 170.50 > $107,000 and ≤ $160,000 > $214,000 and ≤ $320,000 121.80 243.60 > $160,000 and ≤ $214,000 > $320,000 and ≤ $428,000 194.90 316.70 > $214,000 > $428,000 268.00 389.80 Part B premiums for individuals who are married, live with their spouse at any time during the taxable year, and file a separate return are: Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate tax return from their spouse: Income- related monthly adjustment amount Total monthly premium amount ≤ $85,000 $0.00 $121.80 > $85,000 and ≤ $129,000 194.90 316.70 > $129,000 268.00 389.80 Medicare Parts C and D monthly premiums vary by plan. Additional information about Medicare premium and deductibles is available from Medicare’s 2015 & 2016 Costs at a Glance and CMS press release.  YEAR-END REMINDERS COBRA If you employed 20 or more employees on at least 50 percent of the business days in 2015, and if you sponsor a group health plan, COBRA will be applicable to the plan in 2016, unless another exception applies. ACA’S EMPLOYER SHARED RESPONSIBILITY: REQUIRED REPORTING AND DISCLOSURE The Affordable Care Act (ACA) imposes two new Internal Revenue Code sections. One requires reporting of minimum essential coverage (MEC); the other requires employers subject to the employer shared responsibility provisions to report on offers of coverage. This reporting is required beginning January 1, 2015, with the first reports due in 2016. The forms for both of these reporting requirements are the Form 1094 transmittal and Form 1095 benefit statement. IRC Section 6055 reporting is accomplished on the B series of the form; the employer shared responsibility reporting is accomplished on the C series. A self-funded employer subject to shared responsibility can satisfy both its IRC Sections 6055 and 6056 reporting obligations by completing all parts of the Form 1095-C. Deadlines for Filing and Distributing Forms 1094 and 1095  File Forms 1094 and 1095 with IRS no later than February 28th of each year (by March 31st of each year if filed electronically). Note, the due date for 2015 forms is February 29, 2016 (or March 31, 2016, if filing electronically)  Furnish Form 1095 to Individuals Individuals listed in relevant Forms 1094 and 1095 must be furnished copy of the relevant Form 1095 annually by January 31st of each year (or, by next business day if January 31st falls on Saturday or Sunday). FORM W-2 REMINDERS  Aggregate Cost of Health Coverage Pursuant to the Affordable Care Act, the Form W-2 must include the aggregate cost of health coverage. For details about this mandatory reporting, see these CBIZ Health Reform Bulletins, Reminder: Fast Approaching Form W-2 Reporting Requirement and Additional IRS page 8
  • 9. December 11, 2015 Guidance on W-2 Reporting Requirement. The aggregate cost information is to be reported in Box 12, using Code DD. As a reminder, employers exempt from electronic W-2 filing requirement, i.e., file fewer than 250 Form W-2s per year, remain exempt from reporting the aggregate cost of health coverage on the Form W-2 until future IRS guidance is issued.  Health Savings Accounts. Employer contributions (including amounts employees elect to contribute via an IRC §125 cafeteria plan) to an HSA are reported in Box 12 - Code W.  Disability Income. Any employee receiving sick pay benefits from a third party payer, such as an insurance company, must be provided a Form W- 2 reflecting these amounts. The employer is responsible for providing the Form W-2 if the third party payer has notified the employer accordingly. The third party payer will provide the employer with the relevant information to be included on the Form W-2. This information must be given to the employee by January 31, 2016, for benefits paid in 2015.  Dependent Care Assistance Programs. Amounts reimbursed through a dependent care assistance program and amounts in excess of the maximum $5,000 exclusion must be reported in Box 10 of the Form W-2. Amounts over the $5,000 exclusion amounts must be included in Boxes 1, 3 and 5.  Group Term Life Insurance. The cost of group term life insurance over $50,000 (Table I rates only, as below) is reported in Boxes 1, 3 and 5. Also, show the amount in Box 12 - Code C. TABLE I – UNIFORM PREMIUMS FOR $1,000 OF GROUP TERM LIFE INSURANCE PROTECTION 5-year Age Bracket Cost per $1,000 of Protection for one Month Under 25 $0.05 25 to 29 .06 30 to 34 .08 35 to 39 .09 40 to 44 .10 45 to 49 .15 50 to 54 .23 55 to 59 .43 60 to 64 .66 65 to 69 1.27 70 and above 2.06  Additional Medicare Tax Withholding on High Earners. The Affordable Care Act imposes a 0.9% increase in the individual’s Medicare tax rate, applicable on earnings in excess of $200,000 in a calendar year. On the Form W-2, the employer would enter the total employee Medicare tax (including any Additional Medicare Tax) withheld on Medicare wages and tips in Box 6 (“Medicare tax withheld”). The employer is also required to report any individual’s wages paid during the quarter exceeding the $200,000 withholding threshold for the year, as well as the withholding liability for Additional Medicare Tax on those wages on the Form 941 series. FORM M-1 FOR MEWAS If you sponsored a multiple employer welfare arrangement (MEWA) in 2015, make certain that you file the Form M-1 annual report by March 1, 2016. As a reminder, all welfare benefit plans required to file a Form M-1 are required to file the Form 5500 regardless of the plan size or type of funding. The Form M-1 can only be submitted electronically through the DOL’s Online Filing System (http://www.askebsa.dol.gov/mewa/). page 9
  • 10. December 11, 2015 MEDICARE PART D DISCLOSURE NOTICE TO CMS The annual report, Creditable Coverage Disclosure Form, must be submitted to CMS describing whether the prescription drug coverage is creditable or not creditable. This filing must be accomplished electronically, and is due within 60 days of the commencement of the plan year. For details about this notice, see CMS guidance and instructions.  ANNUAL NOTICE REMINDERS Following are certain plan sponsor notification obligations that must be provided on an annual basis to plan participants.  Summary Annual Report Plans subject to Form 5500 reporting are required to provide a Summary Annual Report with specific information derived from Form 5500. The SAR is required to be provided to plan participants within 9 months after close of plan year.  Annual Women’s Health and Cancer Rights Act (WHCRA) Notice This notice describes plan coverage of mastectomy, reconstructive surgery, prosthesis and treatment for physical complications. It can be provided as a separate written notification, or included in a plan’s annual enrollment materials.  Medicaid/CHIP Premium Assistance Notice This notice describes availability of premium assistance from Medicaid or CHIP toward employer-sponsored coverage. It must be provided to all employees who reside in states offering premium assistance. The notice can be distributed as a separate written document, or included in a plan’s annual enrollment materials.  Medicare Part D - Creditable Coverage Disclosure Notice This notice must be provided prior to Medicare’s annual enrollment period (October 15th through Dec 7th ). The notice must be provided to all Medicare-eligible individuals, including employees, former employees, and Medicare-eligible dependents, who are covered by the plan, or who become eligible to enroll in the plan.  401(K) PLAN NOTICES Participants in 401(k) plans must be furnished certain information relating to the plan, including annual and quarterly fee disclosures. A comparative investment chart must be included with the annual participant disclosure. In addition, 401(k) plans are obligated to provide an annual notice of automatic enrollment and qualified default investment alternative (QDIA) notice, if applicable to the plan. ABOUT THE AUTHOR: Karen R. McLeese is Vice President of Employee Benefit Regulatory Affairs for CBIZ Benefits & Insurance Services, Inc., a division of CBIZ, Inc. She serves as in-house counsel, with particular emphasis on monitoring and interpreting state and federal employee benefits law. Ms. McLeese is based in the CBIZ Kansas City office. The information contained in this At Issue is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations. This information is provided as general guidance and may be affected by changes in law or regulation. This information is not intended to replace or substitute for accounting or other professional advice. You must consult your own attorney or tax advisor for assistance in specific situations. This information is provided as-is, with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein. page 10