The recent spread of the Ebola Virus from West Africa into the United States has raised health concerns considerably throughout the nation. It is imperative for employers and employees to take preventative steps and recognize the symptoms of the dangerous virus. To assist with this, Ipswich Bay Advisors has created a flyer for employers to use that will answer the basic questions its employees may have regarding the Ebola virus. The flyer also provides helpful information on the precautions each individual should take to ensure the safety of each individual and his or her family. Below please find a copy of the flyer we sent out to employers. If you have any questions, please feel free to contact Ipswich Bay Advisors at (978)-777-6554.

The Ebola Virus

Ebola Defined

Ebola is an infectious disease that invades and attacks the body caused by the Ebola Virus.

Recognizing the Symptoms

There are several symptoms associated with Ebola with the most noticeable symptom being inexplicable bleeding or bruising. Other symptoms may include: a fever greater than 101.5 F, muscle pain, diarrhea, weakness, vomiting, severe headache, and abdominal pain. It typically takes between 2-21 days for symptoms to emerge after being exposed to Ebola. The Ebola virus is NOT an airborne disease and can only spread after symptoms begin. A blood test can be used to determine if an individual is infected with the virus.

Limiting Your Exposure Risk

Individuals working in the healthcare industry ultimately have the greatest threat for contracting the virus. These workers have the highest risk of contracting the disease because Ebola can be contracted by contact with the blood or bodily fluids of an infected person or by any objects the infected person may have come in contact with.

Infected animals can also transfer the virus so it is important to avoid contact with these animals. Animals such as bats, monkeys, and baboons have been known to carry the Ebola virus. Individuals should avoid consuming any meat products produced by these animals.

Individuals who have recently visited infected areas in West Africa such as Liberia are also at a high risk for contracting the virus. It is recommended that these individuals inform their physician immediately if they have traveled to these areas within the past month. In future trips, it is advised individuals avoid medical facilities where the Ebola virus is present.

The best prevention for Ebola is to avoid anything an infectious patient may have come in to contact with and maintain good personal hygiene.

Treating Ebola

Currently, there is no drug available to cure or treat the Ebola virus. Recovery from Ebola, while unlikely, is possible through the combination of a strong immune system and excellent medical care. As with many other diseases, early diagnosis and treatment greatly increases a patient’s chances for survival. It is imperative to seek immediate medical attention if you begin to show symptoms of the virus or if you believe you may have become infected with the virus.

For more information on Ebola, visit the Center of Disease Control’s website at www.cdc.gov

Medicare Part D Creditable Coverage Notice

Prior to October 15^th each year, employers who provide health insurance benefits to their employees that contain prescription drug coverage are required by the Medicare Modernization Act to notify Medicare eligible employees if their prescription drug coverage provides creditable coverage.  Creditable coverage means the employee’s prescription drug coverage is expected to pay, on average, as much as the standard Medicare prescription drug plan.

There are two important disclosure notice requirements the employer needs to provide to employees. First, a written disclosure notice must be sent to all Medicare eligible individuals and their dependents once a year prior to the October deadline.  This notice also needs to be provided to the employee when he or she first signs up for the plan as well.  In addition to the actively working individuals, any Medicare eligible retirees, COBRA individuals, or disabled individuals and their dependents must also be provided with the creditable coverage disclosure notice.

Secondly, employers must complete the Online Disclosure form and submit it to the Centers of Medicare & Medicaid Services annually.  This form reports the creditable coverage status of the employer’s prescription drug plan and must be completed within the first 60 days of the plan year, within 30 days after any change in creditable coverage status, or within 30 days after termination of a prescription drug plan.

                The Creditable Coverage Notice is available on the Centers for Medicare & Medicaid Services website or you may contact our office for a copy of the template.  If your health insurance plan does not provide creditable prescription drug coverage, you can also find the Non-Creditable Coverage Notice on the Centers for Medicare & Medicaid Services website or you may contact our office for this template as well.

If you have any questions regarding the Medicare Part D Creditable Coverage Notice, please feel free to contact our office at (978)-777-6554. Thank you.

State Employer Poster Requirements

In Massachusetts as well as in all other 50 states, employers are required to display certain posters regarding State and Federal laws.  Since State and Federal laws change periodically, employers should make sure the posters they have are up to date.  Please see below for a complete list of the required posters that need to be displayed in an employer’s place of business in Massachusetts. 

Poster	Governing Agency	Agency Phone Number	Agency Website	Statute
Massachusetts Wage & Hour Laws	Office of the Attorney General	(617) 727-3465	www.mass.gov/ago	M.G.L. ch.151 §16
Fair Employment Law	Massachusetts Commission Against Discrimination	(617) 944-6000 voice For hearing impaired relay services, call 1-800-439-0183	www.mass.gov/mcad	M.G.L. ch.151B §7
Maternity Leave Act	Massachusetts Commission Against Discrimination	(617) 944-6000 voice For hearing impaired relay services, call 1-800-439-0183	www.mass.gov/mcad	M.G.L. ch.149 §105D
Sexual Harassment (model policy & poster)	Massachusetts Commission Against Discrimination	(617) 944-6000 voice For hearing impaired relay services, call 1-800-439-0183	www.mass.gov/mcad	M.G.L. ch.151B §3Ac
Information on Employees’ Unemployment Insurance Coverage	Department of Unemployment Insurance	(617) 626-6535	www.mass.gov/dua	M.G.L. ch.151A §62A
Notice to Employees	Department of Industrial Accidents	(617) 727-4900	www.mass.gov/dia	M.G.L. ch.152 §22
Right to Know Workplace Notice  (for public sector workplaces)	Department of Labor Standards	(617) 626-6975	www.mass.gov/dols	M.G.L. ch.111F §11
Smoke Free Workplace	Department of Public  Health	(800) 992-1895	www.mass.gov/mtcp	M.G.L. ch. 270 §22

For a complete list of the Federal poster requirements, please visit the Department of Labor’s website at http://www.dol.gov/compliance/topics/posters.htm.  Certain posters may be downloaded directly from the websites.  If you have any questions regarding any of these poster requirements, please contact our office.

Thank You.

Medical Loss Ratio (MLR) Rebate

Your company may have recently received information from your health insurance carrier regarding a Medical Loss Ratio Rebate.  As part of the Health Care Reform legislation it requires a certain percentage of the employers premiums to go towards medical claims versus administration expenses.  In addition, Massachusetts has its own regulations and for small groups in Massachusetts it is 90%.  Your company may be entitled to a rebate if your health insurance carrier contributed less than 90% of your group’s premium toward medical claims.   

There are two different ways the employer may use the rebate.  The employer may keep the amount given to them and use it toward future premium costs.  Or the employer may give the refund back to the employees.  The health insurance carriers have begun to mail out rebates to Massachusetts employers.  If you are unsure of how to distribute the refund, please visit the link below to the Department of Labor’s website for additional information.  Please visit “The Best Bottom Line” to remain up to date on Health Care Reform as well as other HR related topics.  Please feel free to contact our office at (978)-777-6554 with any questions you may have.

http://www.dol.gov/ebsa/newsroom/tr11-04.html.

Thank You.

Employer Mandate & Exchange Notices

Good Afternoon,

Beginning in 2015, employers are required to provide their full-time employees with a health insurance plan that is affordable.  If an employer does not provide affordable coverage and a full-time employee receives a tax credit by purchasing a health insurance plan through an Exchange, the employer will be subject to penalties and fines.  This regulation is better known as the Employer Mandate.  It is important to remember that the Employer Mandate only applies to employers with 50 or more employees.  The Employer Mandate does not take effect until 2015, but beginning in April of 2014 health insurance Exchanges will begin to provide notices to employers informing them of which employees purchased a health plan through an Exchange and received a tax credit.  Please note if an employer receives a notice in 2014 these notices won’t be as important as notices that are received in 2015 since the Employer Mandate has been delayed until 2015.  The notices will be provided to inform the employer of any employee who received a tax credit through the Exchange.  It will not differentiate if the employee was a full-time employee or a part-time employee.  This is why it is critical for the employer to have a proper method in place for handling these notices and appealing them if the notices are inaccurate.

If an employer receives an Exchange notice, these notices should be directed to your HR department or your company’s payroll administrator.  These departments will have the capability to track and note which employees received a tax credit through the Exchange.  These departments will also be able to differentiate which employees were part-time or full-time and provide the proper documentation to appeal a notice that may be inaccurate.  Employers should make all employees who handle the company’s mail aware of these notices and inform them of which department to direct the notice.  It is imperative the proper department receives these notices as they will have 90 days to appeal if the notice states a full-time employee received a tax credit.  If the notice is inaccurate and the employer does not appeal within the 90 days then the employer would be responsible for the fine or penalty.

If your company has received an Exchange notice and you have questions regarding it or need a solution on how to track these notices, please contact our office. 

Thank You.

Employee Hour Reductions & ACA Penalties

One of the requirements included in the Health Care Reform legislation is for employers to provide their full-time employees with health insurance.  If employers do not provide health insurance to its full-time employees, the employer will be subject to financial penalties.  This part of the Health Care Reform regulation is better known as the “Employer Mandate” which pertains to employers with at least 50 or more full-time employees.  A full-time employee is defined as an individual working 30 or more hours per week.  In order to fall under 50 full-time employees and escape any potential penalties or fines, employers may want to reduce their full-time employee population.  One way the employer may decrease their full-time staff is by limiting the amount of hours worked to fall below 30 hours per week.  If an employer decides to restrict the number of hours current full-time employees work, this may be a violation of ERISA Sec. 510 and can result in additional fines for the employer.

ERISA Sec. 510 states employers are not allowed to penalize employees from benefit plans that they or their dependents in which have a right to participate.  As stated above, if an employer decides to restrict or limit the amount of hours a full-time employee works, this could be seen as a violation of ERISA Sec. 510.  In this case, the employer is trying to limit their full-time employee population access to benefits in order to fall below 50 full-time employees.  If employers do decide to lower employee hours, it should be well documented and communicated as to why the reduction in hours is occurring.  For newly hired employees, employers may want to decide to create new policies that will reference an hour’s limit for recently hired employees.  It is always recommended to seek the advice of an attorney or consultant regarding ERISA and its impact with ACA when changes may occur within your organization.

If you have any questions or concerns regarding the “Employer Mandate” and how it may impact your company, please feel free to contact me at my office.

Thank You.

Cost Estimations for Medical Procedures

Beginning in the Fall of 2013, a new law was passed in Massachusetts that would require health insurance carriers to provide individuals with a cost estimate for upcoming medical procedures.  By providing individuals with cost estimates for their medical procedures, this will allow individuals to compare prices among different facilities and choose a facility with the lowest price.  Being able to know the cost for the procedure beforehand will allow for individuals to budget properly for this expense.  The goal of this law is to provide individuals with a better sense of cost transparency and what they can expect to pay for their medical procedures. 

The process of obtaining an estimate for a procedure is quite simple.  Individuals call their health insurance carrier and ask for a cost estimate for their medical procedure.  The health insurance carriers are required to provide each individual with the cost of the procedure within two days of the initial call. 

Within the next year, the health insurance carriers will be required to provide the individual with this information instantaneously.  The cost of the procedure or exam will be determined by the type of health insurance plan the individual is enrolled in.  This means health insurance carriers will need to know if individuals will be subject to a deductible or a copayment for these services.  If the health insurance carriers provide an individual with an estimate that is lower than the actual cost of the procedure then the health insurance carriers will be responsible for paying the difference.  If the individual has to have additional tests due to the result of his or her procedure, the health insurance carriers will not be responsible for any treatment or service above and beyond the initial quote. 

Since health care providers will be providing cost estimates for procedures, the goal is to lower the cost of these procedures since the cost information is now available.  This new law will benefit consumers and provide them with important information regarding the cost of their medical procedure.

Please contact our office if you have any questions on how to obtain a cost estimate from your health insurance provider.

Thank you.