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EEOC Provides Guidance on Wellness Programs

Health care reform encourages employees to adopt wellness programs by increasing the maximum amount of rewards or penalties that can be part of a wellness program. However, the EEOC has put a damper on wellness programs recently by filing lawsuits against employers adopting wellness programs. That is, the EEOC has taken the position that just because the wellness program complies with the rules under health care reform does not necessarily mean the wellness program passes muster under other laws. Namely, the EEOC has concerns that the wellness program comply with the ADA (i.e. Americans with Disabilities Act). The EEOC has issued proposed rules listing the ADA requirements applicable to wellness programs.

This is kind of a big deal so it is important you understand the rules if you are sponsoring (or thinking about adopting) a wellness program. Here are three really good articles on the topic.

Government Continues to Issue Guidance

Like it or not, health care reform continues to chug along and, to that end, the government continues to issue materials designed to help with compliance.

The first link is to a simple brochure about IRS Form 1095-B. The second link is to an IRS webpage listing information about the reporting requirements. Remember, employers with at least 50 full-time and full-time equivalent employees have to complete IRS Form 1095 for the 2015 calendar year.

Seven Ways to Cut Health Care Trends

There are no silver bullets when it comes to controlling health care costs. This short article talks about seven ideas that may save money.

This is a good article but I don’t want to create any false hope that this is the answer to all your concerns. However, it is worth reading.

Don’t take away my Cadillac!

People are starting to focus in on the Cadillac tax, which is scheduled to kick in January 1, 2018. Do not (I repeat) do not get your hopes up, but legislation was recently introduced to repeal the Cadillac tax.

Health care reform is expensive and there has to be some way to pay for it. The Cadillac tax is projected to raise a lot of money. So I am not sure how health care reform will survive without the Cadillac tax there to raise money. Also, Congress and the President are not on the best of terms so it is extremely doubtful the President would sign any law that repeals or waters down the Cadillac tax.

COBRA Can Still Bite

COBRA has been around since 1985 and there are no signs it is going away. As a practical matter, fewer people will elect COBRA now that there are the health care exchanges or marketplaces. That is, people now have a viable alternative to COBRA coverage but that does not mean COBRA is going away any time soon.

This article talks about a couple of recent COBRA cases. The real exposure to employers is failing to comply with the notice requirements. Again, few people will elect and pay for COBRA coverage when they can go to the exchanges or marketplaces and get subsidized coverage. However, the employer still could be penalized for not complying with the notice requirements.

A Primer on Stop Loss Policies

Traditionally self-funded health plans were only for larger employers. However, with health care reform, the carriers are developing self-funded products for small employers. This is an excellent article on stop loss policies.

If you are considering self-funding your health plan, it is critical that you fully understand all the risks and this article goes a long way in explaining things to consider when shopping stop loss policies.

Individual Mandate Too Low – Duh!

One of the main components of health care reform is the individual mandate. The individual mandate says most Americans must have health coverage or pay a penalty. However, the penalty is so low that many younger healthier people will opt to pay the individual mandate penalty rather than pay for the health coverage.

The real intent to the individual mandate was not to raise revenue but to force the younger healthier people to buy coverage so as to spread the risk. It does not appear that is happening and, as a result, the premiums are going to go up because only the older and sicker people will sign up for the coverage.

What is Plan B?

The US Supreme Court will soon rule whether the premium subsidies are available to individuals that signed up for health coverage through Federally run health care exchanges or marketplaces. It is difficult to predict how the Court will rule. However, several Republican Senators have issued proposed legislation if the Court rules that the subsidies are only available through state run exchanges.

It is premature to say how the Court will rule. Also, it would be relatively easy to “fix” the statute to allow for subsidies to be available through the federally run exchanges. However, with the political climate in Washington the easy fix may not happen if the Court’s decision is not favorable.