benefits experts

Ask the Experts: FSA Limits | North Carolina Employee Benefits

Question: Our company offers flexible spending accounts (FSAs) for health care and dependent daycare. Our plan limits are the maximum amounts allowed by federal law. Will the IRS increase the limits for 2019? We hold open enrollment in November for employees to make their FSA elections for the following year.

Answer: The maximum annual limits for Dependent Care FSAs and Health Care FSAs are set forth under § 129 and § 125, respectively, of the Internal Revenue Code.

The § 129 (Dependent Care) limits do not change from year to year. They are currently $5,000, or $2,500 if married and filing separately, and they apply on a calendar-year basis. To change them would require a change in law, which is unlikely in the current Congress.

On the other hand, the maximum limit for elective contributions to a Health Care FSA (HFSA) may change from year to year depending on inflation. The limit applies on a plan-year basis and the HFSA limit for a 12-month plan year beginning in 2018 is $2,650. The limit is one of over 50 different tax provisions that is subject to annual cost-of-living or inflation adjustments. Each fall, the IRS announces any changes for the following year. The announcement usually is released in mid-October, which should give employers time to prepare 2019 enrollment materials.

Based on estimated inflation, it appears the HFSA limit will increase from $2,650 for plan years beginning in 2018 to $2,700 for plan years beginning in 2019. The increase will not be official, however, until the IRS announcement is released.

Originally published by www.thinkhr.com

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Is Your Health Plan Affordable for 2019? | North Carolina Benefit Advisors

The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play or pay penalties by offering all full-time employees at least one group health plan option that meets two standards: It provides minimum value and it is affordable.

Minimum value means the plan’s share of total allowed costs is at least 60 percent and the plan provides substantial coverage of physician services and inpatient hospital services.

Affordable means the employee’s required contribution (payroll deduction) for self-only coverage, if elected, does not exceed a certain percentage of the employee’s household income. The affordability percentage changes slightly each year based on the law’s indexing rule. For 2018, the percentage is 9.56 percent. For 2019, however, the percentage increases to 9.86 percent.

Although the change is minor, it means that employers may increase their plan’s employee-only contribution rate and still meet the affordability standard next year.

Determining Affordability

The first step in determining whether a group health plan option is affordable is to define the employee’s “income.” Employers do not know their workers’ total household income, so the play or pay rules offer employers three optional safe harbor methods to define income using information known to the employer. Employers may use any of the safe harbor methods. They also may use different methods for different classes (such as one method for hourly employees and another method for salaried employees), provided that the chosen method is applied uniformly to all employees in the class.

The three IRS safe harbor methods are:

1. Federal Poverty Line (FPL)

The FPL method is the easiest of the three methods. Multiply the mainland FPL amount for a single-member household by the affordability percentage, then divide by 12. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2018: ($12,060 x 9.56%)/12 = $96.08 per month

  • 2019: ($12,140 x 9.86%)/12 = $99.75 per month

The FPL chart is updated every year in late January. For 2019 calendar-year health plans, the employer needs to refer to the current FPL amount ($12,140) since the new FPL amount will not be available until after the plan year starts. If the health plan year starts February 1, 2018 or later, however, the employer may refer to the new FPL amount which likely will be a little higher.

2. Rate of Pay

This is the most convenient method to define income when applied to hourly employees. Multiply the employee’s hourly rate of pay times 130 hours per month (regardless of how many hours he or she actually works), then multiply by the affordability percentage. As long as the self-only contribution rate does not exceed the resulting amount, the plan’s coverage is deemed affordable. For instance:

  • 2018: ($11* x 130) x 9.56% = $136.70 per month

  • 2019: ($11* x 130) x 9.86% = $140.99 per month

* Replace $11 with the hourly employee’s rate of pay.

For salaried employees, the rate of pay method is somewhat complicated so employers generally avoid using this method for non-hourly employees.

3. W-2

The W-2 method requires using current W-2 wages instead of looking back at the prior year. W-2 wages means the amount that will be reported in Box 1 of Form W-2. Pretax contributions, such as § 125 plan contributions and 401(k) or 403(b) plan deferrals, are not included in Box 1, so using the W-2 safe harbor method may understate the employee’s actual income. Coverage will be deemed affordable if, for each month of the plan year, the self-only contribution does not exceed the Box 1 amount multiplied by the affordability percentage.

Summary

Large employers can avoid the risk of potential penalties under the ACA’s play or pay rules by ensuring that they offer full-time employees at least one minimum value plan option that also is affordable. Affordable means the employee’s contribution to elect self-only coverage would not exceed a certain percentage of the employee’s income.

The percentage used to determine affordability changes from year to year is based on the law’s indexing formula. For 2018 plan years, the affordability percentage is 9.56 percent, but it increases to 9.86 percent for 2019 plan years. Employers and their advisors will want to keep this information in mind as they finalize their group health plan offerings and employee contribution rates for 2019.

Originally published www.thinkhr.com

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New Federal Contract Compliance Directives | North Carolina Employee Benefits

On August 24, 2018, the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) announced the following three directives:

  • Guidance for Contractor Compensation PracticesDirective 2018-05 clarifies the OFCCP’s approach to conducting compensation evaluations, supports compliance and compensation self-analyses by contractors, and improves compensation analysis consistency and efficiency during compliance evaluations.
  • Contractor Recognition Programs: Directive 2018-06 establishes a contractor recognition program with awards that highlight best practices, a contractor mentoring program, and other initiatives that provide opportunities for contractors to collaborate or provide feedback to OFCCP.
  • Affirmative Action Program Verification Initiative: Federal contractors are legally required to take steps to ensure equal opportunity in their employment processes, including developing a written affirmative action program within 120 days of when the contract begins. Directive 2018-07 establishes a program for verifying compliance with these and other affirmative action obligations.

The OFCCP enforces federal laws that prohibit federal contractors and subcontractors from discriminating on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. In addition, contractors and subcontractors are prohibited from discriminating against applicants or employees because they inquire about, discuss, or disclose their compensation or that of others, subject to certain limitations.

Originally published www.thinkhr.com

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Intro to Self-Funding | North Carolina Benefit Advisors

The topic of Self-Funding is huge, so let's break it down into smaller bites to digest.  Check out this great video on it!

The New War on Drugs: Opioid Outliers Detectable in Health Plans

Opioid addiction is a growing epidemic in the United States, with opioid overdoses killing 91 Americans every day. In 2015 alone, more than 33,000 people died from an opioid overdose. Read on to learn more about opioids and to learn how to recognize the signs of opioid addiction.

Avoid Costly Mistakes with FMLA

Avoid Costly Mistakes with FMLA

Having a paid family leave policy reinforces an organization's commitment to a family-friendly culture.  More importantly, there is more competition these days for talent and with more millennials entering the workforce they are seeking family-friendly policies that will allow them to have more work/life balance. 

Employees get "a free expert" with every open enrollment

Employees get "a free expert" with every open enrollment

Technology makes it easier to do just about everything. It simplifies and speeds banking and paying bills. It allows people to stay connected with colleagues, friends and family in numerous ways. It enables collaboration, creativity and research. But relying on technology alone to solve connectivity challenges can be problematic. Connectivity takes a human touch and that goes the same for employee benefits.

Custom Benefits Solutions Starts a Monthly Newsletter

Be one of the first to sign up for our new monthly newsletter!  You'll have plenty of cool resources at your fingertips.  Learn benefit tips and tools to help understand your insurance plans better.  Get "tricks of the trade" from the experts.  Have "real life" explanations of why insurance is the way it is.  Ask questions, get answers.  It's not your typical newsletter.  You'll really like it!  Fill out the form below.  That's all you need to do!  You'll be connected with a cache' of resources to help you manage your employee benefits plans in a much smarter way.

Accolades...

Cristy Gupton has been honored by the National Association of Health Underwriters with the Leading Producer's Round Table Soaring Eagle Award.  The Leading Producer's Round Table sets apart leaders in the benefits industry as experts in their trade and professionals who have a very respectable level of success.