This webinar covers: what coverages are subject to the tax, how the excise tax is determined, what adjustments will be available in determining the tax, and who collects the tax.
This webinar covers a basic review of the requirements under ERISA, including: what is an ERISA benefit, what documentation requirements have to be met, what disclosure requirements have to be met, what reporting requirements need to be met, what is a fiduciary, and what are other requirements.
The Marketplace: What Every Employer Should Knowbenefitexpress
This presentation helps assist employers in talking to their employees about the Marketplace. It will cover all you need to know about the Marketplace.
Independent Contractor or Employee: Avoiding the Game of Guess Whobenefitexpress
Uber is in the news for a multimillion dollar settlement following a dispute over whether their drivers are employees or independent contractors, and they aren’t the only ones. Misclassifying an employee as an independent contractor is one of the costliest mistakes an employer can make.
Sort out which your employees are and learn your options for reclassifying workers in the webinar you literally can’t afford to miss.
Temporary Employees and the Employer Mandatebenefitexpress
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This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
Completing ACA Reporting for Employers With Self-Insured Coveragebenefitexpress
This presentation reviews how to complete Forms 1094-C and 1095-C for employers with self-insured coverage, in addition to: What codes to use in lines 14 and 16 of Form 1095-C | What boxes should be checked on line 22 of Form 1094-C | How Form 1094-C has to be completed if your employer is a member of a controlled group | Reporting for COBRA participants, retirees, and other non-employees for self-insured coverage
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
This webinar covers a basic review of the requirements under ERISA, including: what is an ERISA benefit, what documentation requirements have to be met, what disclosure requirements have to be met, what reporting requirements need to be met, what is a fiduciary, and what are other requirements.
The Marketplace: What Every Employer Should Knowbenefitexpress
This presentation helps assist employers in talking to their employees about the Marketplace. It will cover all you need to know about the Marketplace.
Independent Contractor or Employee: Avoiding the Game of Guess Whobenefitexpress
Uber is in the news for a multimillion dollar settlement following a dispute over whether their drivers are employees or independent contractors, and they aren’t the only ones. Misclassifying an employee as an independent contractor is one of the costliest mistakes an employer can make.
Sort out which your employees are and learn your options for reclassifying workers in the webinar you literally can’t afford to miss.
Temporary Employees and the Employer Mandatebenefitexpress
This presentation reviews - when temporary employees become your employees, the factors the government uses to determine employment status, the steps you can take to avoid these employees becoming your employees, and consequences under Health Care Reform if it is determined that they are your employees.
This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
Completing ACA Reporting for Employers With Self-Insured Coveragebenefitexpress
This presentation reviews how to complete Forms 1094-C and 1095-C for employers with self-insured coverage, in addition to: What codes to use in lines 14 and 16 of Form 1095-C | What boxes should be checked on line 22 of Form 1094-C | How Form 1094-C has to be completed if your employer is a member of a controlled group | Reporting for COBRA participants, retirees, and other non-employees for self-insured coverage
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
Employee vs. Independent Contractor - How to Differentiate and Avoid Penalties?benefitexpress
This presentation reviews: which factors the IRS uses to determine common law employee status | how does this affect compliance with ACA | what penalties may apply.
Completing aca reporting for employers with insured coveragebenefitexpress
This webinar reviews how to complete Forms 1094-C and 1095-C for employers with insured coverage, in addition to: what codes to use in lines 14 and 16 of Form 1095-C | what boxes should be checked on line 22 of Form 1094-C | how Form 1094-C has to be completed if your employer is a member of a controlled group | reporting for COBRA participants, retirees, and other non-employee issues.
6 Facts/Updates You Must Know About the Employer Mandatebenefitexpress
This webinar covers:
• What is a large employer and how to determine it?
• Coverage requirements
• Penalties
• Who is a full time employee and how to determine it?
• Who is a variable hour employee?
• Reporting requirements
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
Understanding Health Care Reform: A Dose of Accounting MedecineJames Moore & Co
The affordable Care Act was signed into law on March 23, 2010 and upheld by the Supreme Court in June 2012. These reform measures will have wide-spread impacts to most businesses and individuals. In this presentation, we discuss the tax consequences, small business health care credits, fees, and provide a summary of the Affordable Care Act and the status of reform.
Review all of the requirements of the Employee Retirement Income Security Act of 1974. Training will go over which employers have to comply, which benefits are subject to ERISA, what documentation employers must provide, and penalties for noncompliance.
With Department of Labor audits on the rise, this presentation reviews all the requirements under ERISA. This includes the requirements for plan documents, disclosures and reporting.
There is a lot of confusion and misunderstanding about what the Affordable Care Act (Obamacare) is and how it will affect your business and employees. It is important to learn how it relates to you, your employees and your business. There are many moving parts and there are changes ahead. Our blog series and webinars will describe what the Affordable Care Act is "in plain English" and keep you up to date on the latest information.
HR Webinar: The American Rescue Plan Act of 2021: New Employer Opportunities ...Ascentis
On March 11, 2021, President Biden signed into law H.R. 1319, the “American Rescue Plan Act of 2021” (APRA). The latest in an extended series of COVID-19 economic relief bills, with a price tag of $1.9 trillion and weighing in at an impressive 628 pages, ARPA will bring cumulative US federal pandemic relief spending to approximately $5.7 trillion. While the new law’s consumer provisions – like direct stimulus payments to about 89% of US taxpayers, extended unemployment benefits, and increased child tax credits – have gotten almost all the press coverage related to this law, as with prior laws (FFCRA, CARES Act, CAA) there are many employer-impacting provisions that have so far “flown under the radar.”
At Ascentis, we’ve hauled out our trusty “HCM radar detector” to hone in on just those provisions which may impact and delight (or maybe not?) employers, and the HR community, around the country.
Piece of Cake: Perfecting the Recipe for ACA Compliancebenefitexpress
Repeal and replace efforts have come and gone - it's time to prepare to comply with the Affordable Care Act for another year.
With chatter and speculation surrounding the ACA, it's easy to lose track of what's required of employers. Our one-hour refresher course covers:
- How to fill out form 1095-C
- Important filing dates
- Common compliance errors
- Penalties for noncompliance
Make this year’s ACA reporting a piece of cake.
Eliott Dear Lawyer is explaining the Role of Employee Benefits. Eliott Dear is a regarded legal advisor in New York. He has over ten years of involvement with his legitimate work.
Please note: Seasonal employees ARE counted in the calculation for FTEs for the month that they work. However, if they work less than 120 days and cause the 50 FT threshold to be breached, then the employer is not considered a large employer.
Employee vs. Independent Contractor - How to Differentiate and Avoid Penalties?benefitexpress
This presentation reviews: which factors the IRS uses to determine common law employee status | how does this affect compliance with ACA | what penalties may apply.
Completing aca reporting for employers with insured coveragebenefitexpress
This webinar reviews how to complete Forms 1094-C and 1095-C for employers with insured coverage, in addition to: what codes to use in lines 14 and 16 of Form 1095-C | what boxes should be checked on line 22 of Form 1094-C | how Form 1094-C has to be completed if your employer is a member of a controlled group | reporting for COBRA participants, retirees, and other non-employee issues.
6 Facts/Updates You Must Know About the Employer Mandatebenefitexpress
This webinar covers:
• What is a large employer and how to determine it?
• Coverage requirements
• Penalties
• Who is a full time employee and how to determine it?
• Who is a variable hour employee?
• Reporting requirements
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
Understanding Health Care Reform: A Dose of Accounting MedecineJames Moore & Co
The affordable Care Act was signed into law on March 23, 2010 and upheld by the Supreme Court in June 2012. These reform measures will have wide-spread impacts to most businesses and individuals. In this presentation, we discuss the tax consequences, small business health care credits, fees, and provide a summary of the Affordable Care Act and the status of reform.
Review all of the requirements of the Employee Retirement Income Security Act of 1974. Training will go over which employers have to comply, which benefits are subject to ERISA, what documentation employers must provide, and penalties for noncompliance.
With Department of Labor audits on the rise, this presentation reviews all the requirements under ERISA. This includes the requirements for plan documents, disclosures and reporting.
There is a lot of confusion and misunderstanding about what the Affordable Care Act (Obamacare) is and how it will affect your business and employees. It is important to learn how it relates to you, your employees and your business. There are many moving parts and there are changes ahead. Our blog series and webinars will describe what the Affordable Care Act is "in plain English" and keep you up to date on the latest information.
HR Webinar: The American Rescue Plan Act of 2021: New Employer Opportunities ...Ascentis
On March 11, 2021, President Biden signed into law H.R. 1319, the “American Rescue Plan Act of 2021” (APRA). The latest in an extended series of COVID-19 economic relief bills, with a price tag of $1.9 trillion and weighing in at an impressive 628 pages, ARPA will bring cumulative US federal pandemic relief spending to approximately $5.7 trillion. While the new law’s consumer provisions – like direct stimulus payments to about 89% of US taxpayers, extended unemployment benefits, and increased child tax credits – have gotten almost all the press coverage related to this law, as with prior laws (FFCRA, CARES Act, CAA) there are many employer-impacting provisions that have so far “flown under the radar.”
At Ascentis, we’ve hauled out our trusty “HCM radar detector” to hone in on just those provisions which may impact and delight (or maybe not?) employers, and the HR community, around the country.
Piece of Cake: Perfecting the Recipe for ACA Compliancebenefitexpress
Repeal and replace efforts have come and gone - it's time to prepare to comply with the Affordable Care Act for another year.
With chatter and speculation surrounding the ACA, it's easy to lose track of what's required of employers. Our one-hour refresher course covers:
- How to fill out form 1095-C
- Important filing dates
- Common compliance errors
- Penalties for noncompliance
Make this year’s ACA reporting a piece of cake.
Eliott Dear Lawyer is explaining the Role of Employee Benefits. Eliott Dear is a regarded legal advisor in New York. He has over ten years of involvement with his legitimate work.
Please note: Seasonal employees ARE counted in the calculation for FTEs for the month that they work. However, if they work less than 120 days and cause the 50 FT threshold to be breached, then the employer is not considered a large employer.
How to Avoid a Head-on Collision with The Cadillac TaxBill Conlan
The Webinar addressed what state and local governments need to know about how other provisions of reform that take effect beginning in 2010 will complicate the challenge of meeting the thresholds – and that the time to begin planning for the Cadillac tax is now.
The presenters provided details on the Cadillac tax and factors that complicate compliance with premium thresholds such as the removal of traditional coverage limits, the increase in the dependent eligibility age, additional fees, mental health parity and the estimated 16 million more Americans who will receive Medicaid.
What Does Health Care Reform Mean for You? G&A Partners
Damon Thompson of G& A Partners examines the Patient Protection and Affordable Care Act (PPACA) that was signed into law on March 23, 2010.
G&A Partners is a comprehensive human resource outsourcing provider.
For more great HR webinars and training visit www.gnapartners.com.
How Does Obamacare Impact Your Business Planning?Tilson
The Supreme Court has upheld the PPACA and its implementation is full steam ahead. Now is the time to begin preparing for the impact on your business and your employees. Many have forgotten the complexity, decisions, and regulatory requirements of this legislation. As we all know, the devil is in the details.
How can you smooth the healthcare reform transition? Learn about the mandates currently in place, the mandates that are coming in the near future, what employers need to do, and what employees need to do. Participants can also ask specific questions about how healthcare reform may impact their organization.
2020 Emergency Relief For Employers Called “Paycheck Protection Plan” Created...CMP
On March 27, 2020, President Trump signed Coronavirus Aid, Relief, and Economic Security Act (CARES Act), aimed at providing financial relief for American businesses in response to the economic fallout from the fast-developing coronavirus (COVID-19) pandemic.
Ted Ginsburg, CPA, JD from Skoda Minotti's Employee Benefits group provides an update on the Affordable Care Act (ACA) for employers who were not subject to it in 2015, but are facing IRS filing requirements moving forward.
Staffscapes, Inc. is a Human Resources Outsourcing firm that specializes in HR, Payroll & Benefits. We recently presented this slide show to a group of Colorado Small Business Owners and Managers and are sharing it with the general public today.
Akash Desai of the Philadelphia Department of Public Health (PDPH) presented on health insurance premium/cost-sharing assistance at the December 2016 meeting of the Ryan White Planning Council.
Similar to Cadillac Tax for Employers 101 - How to Avoid Penalties? (20)
Webinar: Mid-Year Election Changes for Cafeteria Plansbenefitexpress
Let's talk about cafeteria plans. When can participants make election changes?
While cafeteria plans can be a great option for employees wishing to pick and choose benefits based on cost, when and how to facilitate election changes outside of open enrollment can be tricky to navigate for employers. As the use of cafeteria plans continue to grow, we take a deeper look at the rules and regulations of these plans, particularly as they pertain to mid-year election changes.
COVID-19 Health & Welfare: Compliance for Employersbenefitexpress
As part of our continuing ERISA Compliance series, we covered such compliance topics and more in our April 9th webinar discussing COVID-19 and updates from the IRS and DOL concerning the Families First Coronavirus Response Act.
Plan Sponsor Webinar: Navigating COVID-19 for Employersbenefitexpress
In this webinar, we take a deeper look into how the novel coronavirus is not only affecting the way we live, but changing the way we work. From remote work environments, FMLA, contract agreements and more, we discuss how to navigate the changing workforce during this time of uncertainty, and answer questions to help you make the best decisions for the health and safety of your employees.
Medicare & Employer Health Coverage - a Coordination Conversationbenefitexpress
Let's talk about Medicare and Employer Health Coverage. The rules on coordinating Medicare and employer coverage can be complex. How it complements other programs (such as COBRA, HSAs and the ACA) are also areas of question for both employees and their employers.
Part of our ERISA Compliance Series, this webinar is hosted by ERISA Attorney Larry Grudzien and moderated by chief marketing officer Julia Goebel. This webinar will discuss the top wage and hour issues that may be unknowingly lurking within your company.
The Affordable Care Act touches the lives of most Americans. In fact, nearly 21 million will be at risk if Obamacare is struck down, and may even lose health insurance completely if the law is ruled unconstitutional. This webinar will discuss what the outcome may be if ACA is repealed.
Watch our free one-hour webinar reviewing the rules for the new Individual Coverage HRA and the new Excepted Benefit HRA (ICHRA and EBHRA).
In June 2019, Treasury, DOL and HHS released final regulations that are effective for plan years beginning on or after January 1, 2020. These regulations created two new HRAs, Individual Coverage HRAs (ICHRA) and Excepted Benefit HRAs (EBHRA).
These new HRAs will be subject to ERISA and COBRA, but will not be subject to the nondiscrimination rules under Code Section 105(h). Any employer can offer these new HRAs to their employees. They can be offered to common law employees, but cannot be offered to self-employed individuals, partners and more than 2% S-Corporation shareholders.
Facilitated by ERISA attorney Larry Grudzien, and moderated by Chief Marketing Officer Julia Goebel, this webinar will cover the following:
-Why are these new HRAs so important?
-Which employees can be included or excluded
-What documentation is needed to be completed by employers to adopt them
-What reporting and disclosure requirements must be met
-What types of expenses can be reimbursed
-The pros and cons of establishing and participating in these new HRAs for employers
In today's multi-generational workforce, health and wellness benefits are weighted equally with salary expectations. This is why it's important for small and large businesses alike to embrace health and wellness benefits to recruit top talent as well as retain valued employees.
While offering these benefits has been shown to improve employee engagement and productivity, it comes with some challenges. This webinar reviews common questions human resources professionals confront when offering health and welfare benefits to employees.
Facilitated by ERISA attorney Larry Grudzien, this webinar covers the following:
- Questions Surrounding Tax
- Reporting Disclosures
- ERISA, COBRA & FMLA
- Workers Compensation
- Affordable Care Act (ACA)
Benefits are a critical piece of an employee compensation package, with health care benefits reigning most important. Whether you're already offering these benefits or considering adding them to your benefits offerings, view our webinar to learn more and remain competitive in the talent marketplace.
How to Administer Wellness Programs in Today's Regulatory Environmentbenefitexpress
Are you struggling to make sense of the recent legislative updates surrounding employer sponsored wellness programs? Perhaps you are trying to decide whether to continue with current wellness plans, modify your plans without guidance from the EEOC, postpone new wellness programs or discontinue them all together.
It’s a complicated landscape ripe with several options for “next steps” for employees and plan sponsors of wellness plans in 2019 — with perhaps the biggest barrier of all being that employers cannot measure the risk of wellness plans at this time.
To help guide you through this maze of options, watch our one-hour webinar on-demand to learn what rules remain after the EEOC’s regulations were found invalid and what rules have to be met in 2019 in order to offer a valid wellness program.
How to administer wellness programs in today's regulatory environment
This webinar covers:
Requirements under HIPAA
Requirements under the Internal Revenue Code
Requirements under ERISA
Requirements under GINA
Requirements under ADA
Requirements under ACA
HIPAA Training: Privacy Review and Audit Survival Guidebenefitexpress
HIPAA Privacy Overview for Employers. Review a helpful checklist of requirements an employer must adopt to stay compliant with HIPAA and to survive an audit by Health and Human Services (HHS).
Webinar | Texas vs. United States - The Repeal of ACA?benefitexpress
Recently a Federal District Court held in Texas, et al. v. United States of America, et al. that the individual mandate in the Patient Protection and Affordable Care Act (ACA) is unconstitutional, and that the other provisions in the ACA are invalid because they are inseverable from the individual mandate.
Our ACA compliance webinar reviews:
- What the Federal District Court decided.
- The basis for the decision.
- The impact of the decision.
- What may happen over the next months or year.
- What Congress may do to address the situation.
Healthcare Check-in: The Latest Developments in Health and Welfare Plansbenefitexpress
We work in an exciting industry – which means quick changes are the norm, and adaptability is a necessity. Keep your compliance plans up to date with a download of all legislative changes since our last update webinar. This webinar covered legislation that's passed in the last six months, what's on the way, and what it means for your organization.
Webinar | From Analysis to Action: How Personalization Can Lower Employer Cos...benefitexpress
Personalization is everywhere – from Amazon to Spotify, and is now the expectation for consumers. Personalization in benefits elections is also the new normal, thanks to decision support tools and data analytics. Modern decision support tools draw on data points including demographics, preferences and medical need, all highly relevant towards personalization ... as opposed to the "one-size fits all" modeler of the past that relied on strict business rules.
Using data to advise clients can be a game changer for a broker. With analytics, you can quantify your benefit plan suggestions based on hard evidence, and advise based on unbiased data versus mere opinion. But where does this data come from? And how do you know which data to use?
This webinar shows how decision support tools can provide data to simplify health benefit decisions, allowing employees to feel more confident in their decisions, leading to lower costs for employers and client retention for brokers as a result.
In this webinar, brokers will learn how decision support analytics can reinforce their role as a trusted adviser by:
• Helping employer clients understand which health plans and programs are being used and which ones are the most cost-effective
• Minimizing the number of employees who are over-insured or under-insured, helping to save on annual and long-term costs for healthcare premiums, leading to better client retention over time
• Supporting healthy employee behaviors, resulting in lower health care expenses overall
FSAs can do some heavy lifting for your benefits plan – they allow employees to save pretax dollars for healthcare costs without the price tag of other financial wellness initiatives.
However, many HR professionals lack a deep understanding of the compliance requirements to offer and administer a well-rounded program for their employees. Engage your employees with a financial wellness benefit that works.
Key webinar takeaways:
- How different types of FSAs interact with benefit plans as a whole
- FSA and reimbursement limits for 2018
- Legal implications of offering an FSA to employees
- Best practices for administering a successful FSA benefit plan
Webinar | COBRA Pitfalls: Common Mistakes and How to Avoid Thembenefitexpress
Leaving the organization isn't the end of the benefits cycle for employees. This webinar focuses on how to avoid one of the most common compliance pitfalls in benefits ... COBRA administration.
Some of the top takeaways were:
• The basics of successful COBRA administration
• Required notices associated with COBRA coverage
• How Medicare interacts with COBRA for employees and dependents
• Penalties for noncompliance
Smooth and successful off-boarding of departing employees is as important as well-planned on-boarding of new hires. Log on to your roadmap for a smooth ride into COBRA compliance.
Webinar | Clients Calling “Mayday”? Design a Benefits Technology Strategy to ...benefitexpress
Benefits administration can be a delicate, and even difficult balancing act for employers. From managing costs and administrative demands, to maintaining compliance, and integrating with workforce wellness plans, it’s not surprising that three in four employers called “mayday” and turned to benefits administration outsourcing in 2017. With the administrative difficulty level rising, and advisory competition increasing, it is now critical to become the partner of choice to relieve this distress. But how?
Join Scott Evans, chief product officer at benefitexpress, this May Day, as he guides benefits advisers through the top considerations for building, buying or borrowing benefits administration technology solutions to offer clients. If you and your clients have benefits technology questions, Scott has answers.
Webinar takeaways include:
• How to assess your readiness: learn and identify the benefits administration business model that is right for you
• Key criteria for evaluating potential benefits technology partners, plus a valuable checklist
• How to create a benefits technology strategy for your business which is seen as an imperative – not a “value-add” – by your clients
• Tips for staying competitive in a changing market, using your solutions portfolio
Webinar | Training the Technique: Advanced ERISA Compliancebenefitexpress
If your organization offers any form of retirement plan, chances are you have questions about ERISA. This advanced compliance training will go beyond the basics of the requirements of the Employee Retirement Income Security Act of 1974.
Attend our one-hour training to learn:
- Which employers are affected by ERISA regulations
- Which benefits plans are subject to ERISA
- What documentation employers must provide to prove
compliance
- Penalties for noncompliance
ERISA attorney Larry Grudzien will share industry inside knowledge to help participants ensure total compliance with ERISA regulations.
Factors of Self-Funding: Evaluating the Pros and Consbenefitexpress
In a changing healthcare landscape, employers are increasingly considering taking the funding of their healthcare benefits into their own hands. If you're one of them, this webinar is the one-hour guide you must see.
Participants will learn:
- The legal implications associated with self-funding
- Common administrative pitfalls
- Solving employee issues involved in self-funded plans
- A full overview of laws and regulations governing self-funding
Our compliance expert will weigh in during a compact, one-hour guide.
Factors of Self-Funding: Evaluating the Pros and Cons
Cadillac Tax for Employers 101 - How to Avoid Penalties?
1.
2.
3. Law of Unintended Consequences
Revenue
• As one of the Affordable Care Act’s principal “pay-fors,” the
Cadillac tax was initially expected to raise $137 Billion in the first
10 years.
• After examining recent cost trends in employer-sponsored health
benefits, that estimate was revised, and now CBO expects the
Cadillac tax will generate about $80 billion over the next 10 years
• True cost next will reveal itself in the next 20 years
4. Medicare Secondary Payer Rules
Purpose / Debate
• Health economists for some time have argued that rich benefit
structures create price insensitivity in consumers who demand
more and more expensive services
• Consumers, plans, and providers need “skin” in the game for
reform to work. Does the Cadillac tax achieve this?
Opposition arguments: public exchange time bomb, employer ante
at health reform table.
5. The Reality
• The Cadillac tax will affect fairly modest plans
• Depending upon source roughly half of employers will hit
thresholds in 2018.
Much higher numbers in the next 10 years
State governments, unions, employers all subject to tax
• Takeaway: Plans can only reduce richness to a point. – Long term
avoidance requires more than benefit buy downs.
• Takeaway: Because much of the Cadillac tax is statutory,
legislation is likely needed to fix big ticket items.
Recent subregulatory guidance will allow employer feedback before
regulations are issued similar to mandate
• Beyond statute interpretation unlikely given recent case.
6. The Basics
Beginning in 2018, employer-sponsored plans will be subject to
a 40 percent non-deductible excise tax on the dollar amount of
coverage that exceeds certain specified thresholds.
• Was originally slated to take effect in 2013 and original thresholds
just indexed to 2018 dollars.
• Why 2018…
2018 threshold for individual coverage is $10,200 and the
threshold for family coverage is $27,500.
• Adjusted by “health cost adjustment percentage”
• Adjusted upwards for early retirees and individuals in high-risk
professions
• Indexed for inflation
7. How does it work?
The Cadillac tax applies to the dollar amount that exceeds the
specified threshold using the following formula:
• “The aggregate cost of the applicable employer sponsored
coverage of the employee for the month, over
• An amount equal to 1/12 of the annual limitation for the calendar
year in which the month occurs.”
Example: If an employer offered individual coverage that cost
$12,000 per employee, the excess amount for a month would be
calculated by ($12,000 / 12 months) − ($10,200 / 12) = $150.
Therefore, the employer would be taxed 40 percent of $150, or $60
per employee per month. Over a year, the Cadillac tax liability per
employee would be $720.
8. Thresholds
• The $10,200 / $27,200 thresholds amounts Increased in 2018 for
Health Cost Adjustment Percentage
• The health cost adjustment percentage is designed to increase the
thresholds in the event that the actual growth in the cost of U.S. health
care between 2010 and 2018 exceeds the projected growth for that
period.
The health cost adjustment percentage is equal to 100 percent plus the excess
(if any) of:
• the percentage by which the per employee cost for providing coverage under the Blue
Cross/Blue Shield standard benefit option under FEHBP for plan year 2018 (determined
by using the benefit package for such coverage in 2010) exceeds such cost for plan year
2010;
• over 55 percent.
• Example: If the cost of standard FEHBP coverage increases by 60
percent from 2010 to 2018, then the health cost adjustment percentage
would be (60 percent − 55 percent) + 100 percent = 105 percent.
Health Cost Adjustment
9. Thresholds
In 2019, the threshold amounts, after application of the health cost
adjustment percentage in 2018, if any, are indexed to the CPI-U, as
determined by the Department of Labor, plus one percentage point,
rounded to the nearest $50.
In 2020 and thereafter, the threshold amounts are indexed to the
CPI-U as determined by the Department of Labor, rounded to the
nearest $50.
Health Cost Adjustment
10. Thresholds
Age and Gender Adjustment
• The $10,200 / $27500 threshold amounts are increased for any
taxable period by the Age and Gender Adjustment
• Is an amount equal to the excess (if any) of—
the premium cost of the Blue Cross/Blue Shield standard benefit option under
the FEHBP Plan for the type of coverage provided such individual in such
taxable period if priced for the age and gender characteristics of all employees
of the individual’s employer, over
the premium cost for the provision of such coverage under such option in such
taxable period if priced for the age and gender characteristics of the national
workforce.
• Example: If the cost of standard FEHBP coverage for the age and gender
characteristics of the employer’s workforce is $11,500 and the cost of
standard FEHBP coverage for the age and gender characteristics of the
national workforce is $10,500, then the age and gender adjustment would
be $11,500 − $10,500 = $1,000.
11. Thresholds
Age and Gender Adjustment
• The IRS is considering whether to use a snapshot approach for
the determination of the age and gender characteristics of a
particular employer's population.
• Employers generally would be required to determine age and
gender as of the first day of the plan year.
• All adjustments and calculations would be determined separately
for self-only coverage and for other than self-only coverage.
• The IRS anticipates developing age and gender adjustment tables
for use in making the calculation.
12. Thresholds
Retirees and High Risk Professions
• The $10,200 / $27,500 threshold amounts are increased for individual
qualified retirees or those who participate in a plan sponsored by an
employer the majority of whose employees covered by the plan are
engaged in a high-risk profession.
• Qualified Retirees: individuals over 55 who are not Medicare eligible and
receiving employer- sponsored retiree health coverage.
• High Risk Professions: Line workers; Law enforcement officers ; Fire
protection personnel; Individuals who provide out-of-hospital emergency
medical care (including EMTs, paramedics, and first-responders)
;Longshoremen; Construction, mining, agriculture (not including food
processing), forestry, and fishing personnel; retirees with 20 years in
these industries.
• In 2018 thresholds for Individual Coverage increased $1,650 or for
Family Coverage increased $3,450.
13. Thresholds
Retirees and High Risk Professions
In 2019, the additional $1,650 and $3,450 amounts are indexed to
the CPI-U, plus one percentage point, rounded to the nearest $50;
and
In 2020 and later years, the additional threshold amounts are
indexed to the CPI-U, rounded to the nearest $50.
14. Thresholds
Retirees and High Risk Professions
Future guidance might explain:
How an employer determines that an employee is not eligible for
enrollment under the Medicare program; and
How an employer determines whether the majority of employees
covered by a plan are engaged in a high-risk profession, what the
term “plan” means in that context, and how an employer determines
that an employee was engaged in a high-risk profession for at least
20 years
15. Thresholds
Indexing
Medical inflation has historically risen faster than CPI-U
Holding everything constant plans will come closer to threshold by
virtue of indexing.
Holding everything constant if subject to the tax the amount will grow
each year.
16. To whom does the Cadillac Tax apply?
• The ACA states that each “coverage provider” is responsible for
payment of the tax.
• In the context of insured group health plans, the coverage
provider is the health insurance company.
For self-insured plans, the entity that administers the plan is the
covered provider responsible for payment of the tax.
• Regulations identify the plan sponsor
HSA contributions the coverage provider is the employer
Other coverage, the administrator
• While the penalties may technically apply to the health insurance
company, the cost of the penalties will be passed down to the
employer.
17. To whom does the Cadillac Tax apply?
The IRS is considering a proposal that would identify the entity
that administers the plan benefits either using:
• the person responsible for performing the day-to-day functions
that constitute the administration of plan benefits; or
• the person that has the ultimate authority or responsibility under
the plan or arrangement regarding the administration of the plan
benefits, even if the person does not routinely exercise that
authority or responsibility.
18. What benefits are included?
• The Cadillac Tax applies to “applicable employer-sponsored
coverage.”
• Applicable employer-sponsored coverage includes coverage
under any group health plan made available to the employee by
an employer which is excludable from the employee’s gross
income or would be excludable if it were employer-provided
coverage.
Major medical coverage and coverage provided under account-based
plans (e.g., FSAs and HSAs) are likely includable in the calculations.
Wellness likely includable if not excepted benefits
• Coverage treated as applicable employer- sponsored coverage
without regard to whether the employer or employee pays for the
coverage.
19. What benefits are included?
Account Based Plans:
• FSAs: Includes the employee’s salary reduction and any
employer contribution
• HSAs: Includes the employer contribution
Proposal to include employee pretax contributions as well
• HRA: Includes full amount of coverage purchased through an
HRA
20. What benefits are included?
• Governmental plans—coverage for civilian employees is included but
military coverage is not included;
• On-site medical clinic coverage; but proposed regulations might exclude
on-site medical clinics that offer only de minimis medical care to
employees;
• Multiemployer plan (as defined in §414(f)) coverage;
• Retiree coverage;
• Coverage described in §9832(c)(3) (which includes coverage only for a
specified disease or illness and hospital indemnity or other fixed
indemnity insurance), if the payment for the coverage or insurance is
excluded from gross income or a deduction under §162(l) is allowed for it;
34 and
• Executive physical programs—proposed regulations might designate
these programs, although not listed in the statute, as applicable coverage
based on the general definition.
21. What benefits are excluded?
Not taken into account in determining the value of employer-sponsored coverage for
purposes of the excise tax are the following
• Long-term care insurance;
• Coverage only for accident or disability income
insurance, or a combination;
• Coverage issued as a supplement to liability
insurance;
• Liability insurance, including general liability
insurance and automobile liability insurance;
• Workers' compensation or similar insurance;
• Automobile medical payment insurance;
• Credit-only insurance;
• Other similar insurance coverage, specified in
regulations, under which benefits for medical care
are secondary or incidental to other insurance
benefits;
• Separately-covered benefits for the treatment of the
mouth or the eye; proposed regulations might
indicate that self-insured limited scope dental and
vision coverage that qualifies as an excepted benefit
under Treasury regulations would be excluded from
applicable coverage, as whether coverage is insured
or self-insured generally is not relevant for purposes
of the excise tax;
• Coverage only for a specified disease or illness or
for hospital indemnity or other fixed indemnity
insurance, if the payment for the coverage or
insurance is not excluded from gross income or a
deduction under §162(l) is not allowed for it; 40 and
• Governmental plan coverage for members of the
military
22. How cost is calculated
The ACA says that the cost of coverage will be determined
under rules similar to the rules used for calculating cost of
coverage under COBRA.
The subregulatory guidance provides detailed methodologies for
determining cost using COBRA rules
Proposal to allow for geographic differences
23. How cost is calculated
The amount subject to the excise tax is the sum of the aggregate
premiums for health insurance coverage, the amount of any salary
reduction contributions to a medical FSA for the taxable year, and
the dollar amount of employer contributions to an HSA or an Archer
MSA, minus the dollar amount of the threshold.
The IRS is considering an approach under which contributions to
account-based plans would be allocated on a previous pro-rata
basis over the period to which the contribution relates, regardless of
the timing of the contributions during the period.
24. How cost is calculated
• The coverage amount that is compared to the dollar limit is based
on the applicable coverage in which the employee is enrolled, not
on the coverage offered to the employee (which might be the
same).
• The aggregate premiums for health insurance coverage include all
employer-sponsored health insurance coverage including
coverage for any supplementary health insurance coverage.
• The applicable premium for health coverage provided through an
HRA is also included in this aggregate amount.
25. Taxable and Determination Period
• Under the statute, the tax is assessed on a calendar-year basis.
• The IRS anticipates that the taxable period will be the calendar
year for all taxpayers.
• The IRS anticipates that employers will be required to determine
the cost of applicable coverage sufficiently soon after the end of
the year to allow coverage providers to timely pay any tax due.
26. Penalty for Failure to Report Correct Amounts
The employer or plan sponsor is subject to penalties for failure to
properly calculate the amount of excess benefit during any period.
The employer or plan sponsor must pay an amount equal to the
additional excise tax due, plus interest at the underpayment rate for
the period.
27. Penalty for Failure to Report Correct Amounts
No penalty applies if:
• the employer or plan sponsor neither knew nor, exercising
reasonable diligence, would have known of the failure; or
• the failure was due to reasonable cause and not to willful neglect
and is corrected during the 30-day period beginning on the first
date on which the employer knew, or exercising reasonable
diligence would have known, of the failure. 68
If a failure to report the correct amount is due to reasonable cause,
the Treasury Secretary may waive this penalty to the extent that its
payment is excessive or otherwise inequitable relative to the failure
involved.
28. Employer Response
• A fight for our life:
Given the indexing issue if thresholds are hit it is unlikely that the most plans will
continue to offer coverage.
• Hard to justify increasing non-deductible business expenses that do not provide
additional benefit to employees.
• At this point mostly compliance focused. Evaluation of plans starting.
• Reducing benefit richness
State benefit mandates
Recruitment and retention issues
Cadillac tax avoiding plans
• More migration to HDHPs
• Likely that only one benefit option will be offered
• Lowest common denominator with stand-alone add o
29. Employer Response
Value Based Purchasing/ Population Health Management
• In its infancy for employers.
Most programs only include provider incentives
• Takes time to bend the cost curve
• Need market share to negotiate
Provider Innovation
• Looking to telehealth, and other non-traditional settings.
30. Congress to the Rescue???
The Middle Class Health Benefits Tax Repeal Act
• Would repeal the Cadillac Tax
• Introduced by Joe Courtney (108 Co-Sponsors (mostly D’s))
The Patient Choice, Affordability, Responsibility, and
Empowerment Act
• Introduced by Burr, Hatch and Upton
• Repeals Cadillac Tax and caps employee exclusion for employer
provided health care at $12,000; $30,000 for family
• Indexed at CPI + 1
31. Congress to the Rescue???
Legislative solution
• Must maintain system transformative qualities
• Must account for regulatory, geographic, and demographic
characteristics of plans
• Must be fiscally responsible