The original deadline for providing this notice to employees was March 1, 2013. The effective date has been changed to October 1, 2013 to coincide with the Exchange or Marketplace open enrollment period, which also begins on that date. Employers who want to start providing notices sooner may follow this temporary guidance and use these model notices. However, employers are not required to provide notices under this temporary guidance and may wait until formal guidance is provided later this year.

Impacted Employers

The notice requirement applies to all employers that are subject to the Fair Labor Standards Act (FLSA). Most employers fall into this category, but there are exceptions.

Following this link may assist employers in making this determination.

 
Recipient and Distribution Requirements

This one-time notice must be provided to all current employees as of October 1, 2013 and to new employees as they are hired. For 2014, if the notice is provided within 14 days of an employee’s start date, the notice will be considered as having been provided at the time of hiring.

Employers must provide a notice to all full-time and part-time employees, regardless of whether the employee is enrolled in an employer-sponsored medical plan.  Employers must provide this notice even if they do not offer any health coverage to employees.

The notice does not have to be provided to employees’ dependents.  Notices must be in writing and can be delivered electronically by the employer if the ERISA standards for electronic delivery are met.
 

What Must be Included in the Notice
 
There are two versions of the model notice:

•    Notice for employers that DO offer medical coverage to some or all of their employees.
•    Notice for employers that DO NOT offer medical coverage to any employees.
Employers can use the model notices or create their own notice as long as the notice includes the following required information:
•    Verbiage that the Exchange or Marketplace exists including a description of the services it provides and direction for employees to visit HealthCare.gov for more information.
•    Employees who purchase coverage through the Exchange or Marketplace may be eligible for a premium subsidy if their employer does not provide coverage that is “affordable” and provides “minimum value.” Coverage is affordable if the employee-only option for the lowest-cost plan offered costs less than 9.5% of an employee’s W-2 wages. Coverage provides minimum value if the plan pays at least 60% of allowed charges for covered services.
•    Employees who purchase coverage through the Exchange or Marketplace will pay for that coverage with after-tax dollars.
•    If applicable, information about the medical coverage the employer offers to its employees.

Changes to COBRA Notice

Employees and dependents who become eligible for COBRA will also have the option to purchase coverage through the Exchange/Marketplace and potentially receive a premium subsidy. The model COBRA notice that employers and COBRA administrators use has been revised to include information about the Marketplace.

Use this link to review the revised COBRA notice.

Next Steps…

We encourage you to use these notice links for additional information in regards to Coverage Options for Employees.

Click here for Guidance on the Notice to Employees of Coverage Options under Fair Labor Standards Act.

Click here to review the Notice of Employers that DO offer coverage.

Click here to review the Notice of Employers that DO NOT offer coverage.

Click here to review the ERISA standards for electronic delivery.

The minimum annual deductible for both individuals and families remains the same.

To see the table for details, view the IRS Revenue Procedure Publication 2013-25

To view the updated inflation adjustment charts click here.

Items affected:

Social Security and Medicare Wage Base

Indexed Compensation levels

401(k) Plans

Health FSA

Adoption Credit

Health Savings Account (HSA)

Archer Medical Savings Account (MSA)

Dependent and/or Child Day Care Expenses

Commuter Accounts

Long-Term Care

Standard Mileage Rates

Congress extended parity for pretax transit and parking benefits through the American Taxpayer Relief Act of 2012 (also known as “Fiscal Cliff” legislation). President Obama signed the legislation on January 2, 2013.  The provision is retroactive to January 2012 and through 2013.  The action increases the pretax transit benefit to $245 a month.    This means that those who take mass transit or participate in van pools are eligible for the same amount as colleagues who drive and park.

Prior to this new legislation, the amount public transportation commuters were allowed to set aside in their pretax accounts each month was disproportionate to those who drove and parked.  The monthly parking costs limit increased to $245 from $230 to account for the cost of living adjustment.  Those who took public transportation were only allowed $125/mo. from $230, a decrease of $105.

For now, the limits are equal but the parity isn’t permanent.  It is subject to future legislative action.

Shopping Strategies

• Before you head to the store, take a few minutes to plan your meals for the week (or however long until you shop again), and make a list of what you’ll need. It’s also a good idea to keep an ongoing shopping list somewhere in your kitchen, so you can add items as you run out.

• To plan healthy meals, focus on the usual suspects: fresh fruits and vegetables, whole grains, nuts, beans, calcium-rich dairy products, and some healthy protein such as poultry, fish, eggs, or tofu. (For more detailed nutritional guidance, see the online resources listed at the end.)

• At the store, concentrate your shopping in the outer aisles, where you’ll typically find fresh foods like fruits and vegetables, dairy, meat, and fish. Avoid the center aisles, which are home to highly processed snacks and other junk foods. It’s also important to read the ingredient labels on foods. They’ll help you quickly separate the genuinely healthy items from the pretenders.

• Another thing: Never shop when you’re hungry. You’re much more likely to succumb to temptation and find yourself in the checkout line with a family-size bag of chips and a half-dozen cupcakes.

 

Eating right is important, because nutrition plays a big part in your overall health. For example, a healthy diet can lessen your risk of certain cancers, obesity, type 2 diabetes, and hypertension, according to the U.S. Centers for Disease Control and Prevention.

With these health eating tips, you should be well on your way:

1. Add color
2. Separate your plate
3. Know portion size
4. Eat your veggies first
5. Avoid processed foods
6. Drink healthy

Click the picture for more detail.

Beginning January 1, 2013, contributions to Flexible Spending Accounts (FSA) for medical related expenses are now limited to $2,500 per year. This includes an annual increase in the amount of the cost of living adjustment. There use to not be a standard limit, though most employers placed a cap at $5,000. The “use it or lose it” rule remains in place.  For the nitty gritty, check out the IRS details here: http://www.irs.gov/pub/irs-drop/n-12-40.pdf

Medical Expense Itemized Tax Deductions effective 1/1/13: Thresholds for claiming itemized tax deductions for medical expenses rise from 7.5% to 10.0% of adjusted gross income. This increase will be waived for those 65 or older for tax years 2013 through 2016.

Medicare Tax Rate Increase effective 1/1/13:  Medicare Part A tax on wages increase by 0.9% (to 2.35%) on earnings over $200,000 for individuals and $250,000 for married couples filing jointly. Also imposed is  a 3.8% tax on unearned income for higher-income taxpayers.

Beginning March 1, 2013, Health and Human Services (HHS) adopted additional guidelines for Women’s Preventive Services in August 2011 – including well-woman visits, support for breastfeeding equipment, contraception, and domestic violence screenings – to be covered without cost sharing in all new plans starting August 2012.  For more details on regulations : http://www.healthcare.gov/law/resources/regulations/womensprevention.html

We encourage you to choose paperless delivery of all of your EOB’s for faster notification and easier access to your claims.  You may log on to www.blueshieldca.com/gopaperless and click Edit next to Manage Paperless Delivery and Alerts to sign up for paperless claims delivery!

You will receive a claim alert when an new EOB is processed, and it will be available online for up to 24 months from the date the claim was processed.

Subscribers who are unable to access their EOBs online may call the customer service number on their Blue Shield ID card to request mailed copies.

Insurers, employers, employees and individuals will continue to be required to comply with the Health Care Reform law as each provision is schedule to be enforced.

For a timeline of this law, I suggest http://www.healthcare.gov/law/timeline/

Will you take the challenge?

To review, HSAs are tax-advantaged medical savings accounts available to taxpayers who are enrolled in an HSA-qualified high-deductible health plan. The policyholder must not be covered by other non-HDHP health insurance or Medicare and cannot be claimed as a dependent on someone else’s tax return. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unused amounts in one year can be carried over to following years and added to subsequent contributions.

HSA Contribution Limits: 

• Individuals (self-only coverage) – $3,250 (up $150 from 2012)
• Family coverage – $6,450 (up $200 from 2012)

HDHP Minimum Required Deductibles:

• $1,250 for self-only coverage
• $2,500 for family coverage

Out-of-Pocket Maximum:

(Out-of-pocket expenses include deductibles, co-payments, and other amounts, but not premiums)

• $6,250 for self-only coverage
• $12,500 for family coverage

Under guidelines implemented in the Patient Protection and Affordable Care Act, over-the-counter drugs may only be reimbursed if they have a prescription. If a policyholder uses an HSA to pay for items or services that aren’t qualified medical expenses, the tax penalty is 20 percent of the HSA distribution.