Carriers Confirm Exchange Participation

Due to volatility in the individual markets, insurance companies have been considering whether to continue to offer exchange coverage in New Hampshire and around the country.

As of today, Anthem and Ambetter have confirmed to the New Hampshire Insurance Department they will offer plans on the state’s exchange in 2018.

Harvard Pilgrim has not yet confirmed its plans.

Minuteman Health did announce in June that it would not offer exchange plans in 2018 as it is ceasing its functions as a co-op. However, Minuteman Health management is in the process of forming a new insurance company and hopes to be able to offer plans on New Hampshire’s exchange under the new company for 2018.

Last week, the federal government extended the rate-filing deadline from August 16 to September 5 for companies to file revised rates with the states for review. Companies may file rates with the assumption that the federal government will not offer reimbursements called “Cost Sharing Reduction payments” to the companies in 2018. While the Insurance Department is prohibited from releasing rate information prior to open enrollment (November 1), the federal government has made publicly available proposed rate increases of 10% or more on its rate review website.

Refer to the below press releases for additional information and contact your NEEBCo representative with any questions you may have.

NH Insurance Department – Anthem Exchange Participation
NH Insurance Department – Ambetter Exchange Participation

IRS Confirms ACA Penalties

The Internal Revenue Service (IRS) Office of Chief Counsel has recently issued several information letters regarding the Affordable Care Act’s (ACA) individual and employer mandate penalties. These letters clarify that:

  • Employer shared responsibility penalties continue to apply for applicable large employers (ALEs) that fail to offer acceptable health coverage to their full-time employees (and dependents); and
  • Individual mandate penalties continue to apply for individuals that do not obtain acceptable health coverage (if they do not qualify for an exemption).

These letters were issued in response to confusion over President Donald Trump’s executive order directing federal agencies to provide relief from the burdens of the ACA.

Refer to the below compliance bulletin for details and contact your NEEBCo representative with questions.

IRS Confirms ACA Mandate Penalties Still Effective

Draft Forms for 2017 ACA Reporting Released

On July 28, 2017, the Internal Revenue Service (IRS) released draft 2017 forms for reporting under Internal Revenue Code (Code) Sections 6055 and 6056.

  • 2017 draft Forms 1094-C and 1095-C will be used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
  • 2017 draft Forms 1094-B and 1095-B will be used by entities reporting under Section 6055, including self-insured plan sponsors that are not ALEs.

Instructions for these 2017 forms have not yet been released. The draft 2017 forms are substantially similar to the final 2016 versions, except that sections related to expired Section 4980H Transition Relief were removed. Once released, the draft instructions may include some additional clarifications.

Employers should become familiar with the planned revisions to the forms. However, these forms are draft versions only, and should not be filed with the IRS or relied upon for filing.

Review the attached Compliance Bulletin for additional information and contact your NEEBCo representative with questions.

Draft Forms for 2017 ACA Reporting Released

Senate Votes On Healthcare Debate

On July 25, 2017, members of the U.S. Senate voted 50-50 to open up the American Health Care Act (AHCA) for debate and amendments in the Senate, with Vice President Mike Pence casting the tie-breaking vote in favor of the measure. The AHCA is the bill to repeal and replace the Affordable Care Act (ACA) that passed in the House of Representatives on May 4, 2017.

As a result of the vote, the Senate will now begin debate on the AHCA, as it was passed by the House. However, amendments are likely to be made to the bill before a final vote is taken. The Senate’s August recess has been delayed by two weeks to accommodate a vote on an ACA repeal and replacement bill.

The Senate has not voted on any ACA repeal or replacement proposal at this time. The AHCA would need a simple majority vote in the Senate to pass.

However, it is likely that the Senate will make changes to the bill before taking a vote. If it passes the Senate, the AHCA would need to go back to the House for approval before being signed into law by President Donald Trump.

Refer to the attached compliance bulletin for details and contact your NEEBCo representative with any questions you may have.

Senate Votes to Take Up AHCA For Debate

NEEBCo Employee Handbook Services

Your employee handbook is an important document. Not only does it help employees understand company policies, promote solid company-employee communication and set a consistent standard of expectations, but it can also have serious legal ramifications.

NEEBCo clients have access to two versions of attorney-reviewed handbooks, modifiable to meet the employer’s needs regarding employment policies, workplace conduct, time away, general practices and procedures, and more.

In many employment lawsuits, your handbook will be a key piece of evidence. It is vital that your handbook is thorough, up to date, legally compliant, understandable and readily available to all employees. It is also wise to make employees sign a form stating that they received and reviewed the employee handbook, so that they cannot later claim during a lawsuit that they were unaware of a particular policy.

The following areas are examples of common legal mistakes employers make with their employee handbook.

Changing Laws and Requirements
It is vital that you update your handbook regularly to comply with new and changing laws, both federal and state. In addition, you should provide employees with all handbook updates (or notify them if the handbook is published online). For significant legal changes, you may want to have employees sign another document acknowledging that they are aware of the altered policy. In addition, it is a good idea to have a disclaimer that the handbook may change at any time.

Employee Rights
Many handbooks make the mistake of outlining employer rights but glossing over the rights of employees. Some employers fear that including employee rights will encourage more employees to file lawsuits, but omitting them leaves you open to significant legal liability.

Employment Relationship
Your handbook needs to be explicit about the at-will employment relationship – that the employer (and the employee) has the right to terminate employment at any time, with or without cause. Also, be sure you don’t have other policies that undermine this one, such as probationary periods (which can sound like employment is guaranteed for at least as long as the period) or progressive discipline policies (which may not clarify that an employee may be terminated at any time).

Exempt or Non-exempt Classification
Wage, hour and overtime complaints are among the most common legal actions taken by employees or former employees. Be sure your handbook is clear in the distinction of exempt and non-exempt, and that all employees are classified properly. Also make sure that your overtime policy complies with state and federal laws. For instance, if you have a policy stating that overtime must be approved, you cannot mandate that unapproved overtime will not be paid – you are legally required to pay it. You can, however, otherwise discipline employees for violating such a policy.

Computer Usage
Your handbook must make clear that the company owns its computers, email and all data, and that nothing on a computer is private. You should also have clear policies if your employees have other electronic company devices.

Follow Through
Providing a comprehensive, compliant handbook is only the first step – your company must always follow through with the policies outlined. For instance, if your handbook discusses a specific procedure for conducting performance reviews, it is important that you follow it.

Because employee handbooks are so important, consider having legal counsel review yours periodically to help keep your company out of legal trouble.

Contact your NEEBCo representative with any questions you may have, or to access the handbook builder templete.

Employee Handbook Services Overview

New Form I-9

On July 17, 2017, U.S. Citizenship and Immigration Services (USCIS), part of the U.S. Department of Homeland Security, issued an updated version of Form I-9: Employment Eligibility Verification (Form I-9). Under federal law, every employer that recruits, refers for a fee or hires an individual for employment in the United States must complete a Form I-9.

The updated form replaces a version that was issued in 2016. Employers may continue using the 2016 form until Sept. 17, 2017. Exclusive use of the updated form is expected by Sept. 18, 2017.

Refer to the attached compliance bulletin for additional details and contact your NEEBCo representative with questions.

New I-9 Published for Use in September

Minuteman Health Announces New Company and Direction

Minuteman Health announced it will be ceasing operations as a Consumer Operated and Oriented Plan (COOP) as of January 1, 2018, and is actively seeking to organize a new Massachusetts health insurer to begin operations on that same date both in Massachusetts and New Hampshire.

Minuteman Health is an HMO authorized to do business in Massachusetts and New Hampshire, beginning operations under the COOP program of the Affordable Care Act (ACA) in 2014. Minuteman Health is referencing the impact of the ACA’s risk adjustment program and imposed restrictions on their business model as the reason for the decision to end the COOP and transition to Minuteman Insurance Company as of January 1, 2018.

The new entity has filed license applications in both states and hopes to fully organize the new insurer in the coming months. Reference the attached press release for additional information and contact your NEEBCo representative with any questions.

Minuteman Health Press Release

DOL Withdraws Worker Classification Guidance

On June 7, 2017, the U.S. Department of Labor (DOL) withdrew a 2015 administrative interpretation on classifying workers as employees or independent contractors. The withdrawal became effective immediately.

Employers are still required to properly classify workers as employee or independent contractors. By withdrawing the 2015 guidance, the DOL is returning to more reliance on existing judicial interpretations of the law’s requirements, rather than providing its own guidance on how employers should follow the law. Employers may want to evaluate whether their current classification procedures are affected by the withdrawal of this guidance.

Refer to the attached compliance bulletin for details about this change and contact your NEEBCo representative with any questions you may have.

DOL Withdraws Worker Classification Guidance

Church-Affiliated Plans Exempt from ERISA

On June 5, 2017, the U.S. Supreme Court issued a decision holding that an employee benefit plan may be exempt from the Employee Retirement Income Security Act (ERISA) as a “church plan” even if a church did not establish it. The court held that the ERISA exemption for church plans applies to certain organizations that are affiliated with churches, regardless of how their benefit plans were established.

Employers with church affiliations should be aware of the specific criteria an employee benefit plan must meet to qualify for ERISA’s church-plan exemption.

ERISA generally defines a church plan as any employee benefit plan “established and maintained” by a church or group of churches. The definition also includes any plan maintained by “principal-purpose organization,” which is an organization that:

  • Is controlled by or associates with a church or a convention or association of churches; and
  • Has a principal purpose or function of funding or administering benefits to the employees of the church or convention or association of churches.

Refer to the attached compliance bulletin and see your NEEBCo representative with any questions you may have.

Supreme Court Rules Church-Affiliated Plans are Exempt from ERISA

2018 ACA Affordability Percentages

For plan years beginning in 2018, the ACA’s affordability contribution percentages are reduced to:

  • 9.56 % under the pay or play rules
  • 9.56 % under the premium tax credit eligibility rules
  • 8.05 % under an exemption from the individual mandate.

These updated affordability percentages are effective for taxable years and plan years beginning Jan. 1, 2018. This is the first time since these rules were implemented that the affordability contribution percentages have been reduced.

Refer to the attached compliance bulletin and contact your NEEBCo representative with any additional questions.

Affordability Percentages Will Decrease for 2018 5-17-17