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.

Health Care Reform Employer Mandate Delay

On Monday February 10^th, the Federal Government issued several updates to the Affordable Care Act.  Below is a listing of the regulation revisions the government provided.

The Employer Mandate by Employee Population Size

Employers who have an employee population between 50 to 99 full-time employees will not be subject to any fines or penalties for not providing their employees and their families with health insurance coverage until the employer’s first renewal period that begins on or after January 1, 2016.  Employers will need to confirm that they will not be downsizing their employee population in order to fall and stay below the threshold of 100 employees.

Employers who have an employee population that is greater than 100 full-time employees will not be subjected to any fines or penalties for only providing coverage to 70% of their full-time population in 2015.  Beginning in 2016, employers will be required to provide health insurance coverage to at least 95% of their full-time employee population.

There has been no change in the definition of a full-time employee which will continue to be classified as any employee who works at least 30 hours or more per week.  There have been changes in the definition of a dependent, which now does not include any step-children or foster children.

2015 Transitional Relief

The Federal Government has provided employers with the final changes pertaining to transitional relief.  The changes will include:

1. Employers whose health insurance plan is categorized as a non-calendar year will be required to conform with the employer mandate on the plan’s first year that begins on or after January 1, 2015.
2. As long as the employer is making strides to provide dependent coverage by 2016, the employer will not be required to offer dependent coverage in 2015.
3. In determining how many full-time equivalent employees an employer has, it is suggested the employer use the “six month” look back period in determining if they have above 100 full-time equivalent employees.
4. Employers will also be able to use this method in determining the stability period for employees whose hours may fluctuate and if the employer is required to offer these employees coverage.

There has also been relief to categorize the coverage obtained through the Marketplace as an allowable Section 125 status change.  This relief will be provided in 2014, but has not yet been determined if it will be extended for future years.

How to Categorize Full-Time Employees

1. Workers in volunteer positions for the government such as volunteer firefighters and first responders will not be categorized as full-time employees.
2. Even though teachers and other education personnel may not work a full year, they are to be categorized as full-time employees.
3. Employers who hire seasonal employees who work less than half a year will not be considered full-time employees
4. Universities and Colleges can attribute 2 ¼ hours of work for adjunct professors for every hour they instruct.
5. Students who participate in a federal or state work study program are not categorized as full-time employees.

Safe Harbors for Affordable Coverage

To determine if an employer provides affordable health insurance coverage, employers may use the federal poverty level, hourly rates, or an employee’s W-2 wages to calculate if the health insurance plan the employer offers is affordable.  If an employer is to use the W-2 safe harbor provision, the employer must report the full wages for the employee which will not be used for any salary reduction elections under the company’s 401(k) plan or the company’s Section 125 plan.

Recently Established Businesses and New Employees

For employers who recently established their business this year, they should classify their company as a large group or a small group based on the total number of employees they expect to hire and have on staff for business days during the current year.

Employees are expected to be provided health insurance coverage by the first day of their fourth month of service.  Employers will not be assessed a fine or penalty for not providing health insurance coverage during the employee’s first three months of service.

COBRA Alternatives

With the recent Health Care Reform changes and the addition of the Health Insurance Marketplace, former employees now have more choices than just electing COBRA to continue their health insurance benefits with their prior employer.  Former employees can elect to continue their benefits under COBRA and are responsible to pay for the full monthly premium cost of the benefit.  As some may know, COBRA premiums can be quite expensive and costly for an individual who may be in between positions.  With the addition of the Health Insurance Marketplace, individuals now have another option versus electing to continue their benefits through COBRA.

The Health Insurance Marketplace allows the individual to choose a health insurance plan that best suits his or her budget versus only having the employer option from which to choose.  The Marketplace offers a wide variety of health insurance plans from multiple carriers.  By having the freedom of choice, the individual can select a plan that best suits his or her coverage needs and is within his or her budget.  In addition, the employee may be eligible for a subsidy from the government to cover some of the costs of the plan. 

Employees may check out the options for the Health Insurance Marketplace here.  For employers with employees in different states, please check with the state the employee is located in to see if a state Health Insurance Marketplace has been established.  If not, please click here to be directed to the Federal Health Insurance Marketplace.

For more information on the Health Insurance Marketplace, please feel free to contact me at my office.  Thank you.