by Lexi Garcia | Feb 21, 2023 | Blog
Everyone in the employee benefits field uses acronyms like COBRA, FSA, and CDHC. What do these and other employee benefit acronyms stand for?
Here’s an explanatory list of common employee benefit acronyms used:
ACA – Patient Protection and Affordable Care Act
AHP – Association Health Plan
ASG – Affiliated Service Group
ASO – Administrative-Services-Only
ATIN – Adoption Taxpayer Identification Number
BA – Business Associate
CDHC – Consumer-Driven Health Care
CE – Covered Entity
COB – Coordination of Benefits
COBRA – Consolidated Omnibus Budget Reconciliation Act
COLA – Cost-of-Living Adjustment
CONUS – Continental United States
DCAP – Dependent Care Assistance Program
DOL – Department of Labor
EIN – Employer Identification Number
EAP – Employee Assistance Plan
EBHRA – Expected Benefit HRA
EBSA – Employee Benefits Security Administration
EEOC – Equal Employment Opportunity Commission
EFAST2 – ERISA Filing Acceptance System II
EOB – Explanation of Benefits
EOI – Evidence of Insurability
ePHI – Electronic Protected Health Information
ERISA – Employee Retirement Income Security Act
FICA – Federal Insurance Contributions Act
FLSA – Federal Labor Standards Act
FMLA – Family and Medical Leave Act
FSA – Flexible Spending Amount
FUTA – Federal Employment Tax Act
GHP – Group Health Plan
HCE – Highly Compensated Employee
HCP – Highly Compensated Participants
HDHC – High Deductible Health Coverage
HDHP – High Deductible Health Plan
Health FSA – Health Flexible Spending Arrangement
HHS – Department of Health and Human Services
HIPPA – Health Information Technology for Economic and Clinical Health Act
HMO – Health Maintenance Organization
HRA – Health Reimbursement Arrangement
HSA – Health Savings Account
ICHRA – Individual Coverage HRA
IIAS – Inventory Information Approval System
MCC – Merchant Category Code
PBM – Pharmacy Benefit Manager
PCOR Fees – Fees for Patient-Centered Outcomes Research
PEO – Professional Employer Organization
POP – Premium-Only Plan
PPO Plan – Preferred Provider Organization Plan
QB – Qualified Beneficiary
QE – Qualifying Event
QMCSO – Qualified Medical Child Support Order
QSEHRA – Qualified Small Employer Health Reimbursement Arrangement
R&C – Reasonable and Customary
RRE – Responsible Reporting Identity
SBC – Summary of Benefits and Coverage
SMM – Summary of Material Modification
SPD – Summary Plan Description
TPA – Third Party Administrator
UCR Rate – Usual, Customary, and Reasonable Rate
VEBA – Voluntary Employees’ Beneficiary Association
by Lexi Garcia | Feb 15, 2023 | Blog
The Internal Revenue Service, Department of Labor, and U.S. Health and Human Services Department have issued proposed regulations that would provide an additional method for individuals to obtain no-cost contraceptive services if their health plan or insurer does not provide such services due to a religious exemption. Under final regulations issued in 2018, qualifying religious employers and other entities with sincerely held religious beliefs or moral convictions are exempt from the Affordable Care Act’s contraceptive coverage mandate, which generally requires coverage of contraceptive services without cost-sharing. Exempt entities may voluntarily engage in an accommodation process that allows plan participants to receive contraceptive services directly from a TPA or insurer without the employer’s involvement. In an FAQ issued in 2021, the agencies announced they were considering changes to the 2018 regulations “in light of recent litigation”. Here are highlights of the proposal:
- Individual Contraceptive Arrangement: Leaving in place the existing religious exemptions and accommodations, the agencies have proposed to add a new “individual contraceptive arrangement” through which individuals enrolled in plans or coverage sponsored or arranged by entities with religious objections could access no-cost contraceptive services without the involvement of their employer, group health plan, plan sponsor, or insurer. A provider or facility that furnishes contraceptive services in accordance with the individual contraceptive arrangement would be reimbursed through an arrangement with an Exchange insurer, which would request an Exchange user fee adjustment to cover the costs.
- Moral Exemption Rescinded: The proposed regulations would revoke the 2018 regulations’ moral exemption and accommodation. The agencies explain that “there have not been a large number of entities that have expressed a desire for an exemption based on a non-religious moral objection” and that there is no legal obligation (including under the Religious Freedom Restoration Act) to provide such an exemption.
Source: Thomson Reuters
by Lexi Garcia | Feb 10, 2023 | Blog
The Biden Administration announced on Jan. 30 its intent to end the public health emergency and national emergency on May 11, 2023. Former President Donald Trump issued the emergency declaration in March 2020 in response to the nation’s COVID-19 crisis. President Joe Biden extended the emergency again on Feb. 18, 2022.
The House of Representatives proposed ending the emergency immediately rather than wait until May 11. The administration responded saying that an abrupt end to the emergency declarations would create chaos within the nation’s health care system.
The 60 days after the end of the national emergency will be significant as benefit related changes will take affect July 10, 2023. For plan sponsors, many benefit-related deadlines were extended as part of the national emergency, such as COBRA election and payment periods. With deadlines extensions ending, plan sponsors should work with COBRA and other third party-administrators in preparation for the rule changes affecting:
- election periods for COBRA continuation coverage
- COBRA premium payments
- HIPPA special enrollments
- claims, adverse decision appeals and external reviews
by admin | Dec 22, 2022 | Blog
The IRS has issued the final versions of Publication 15 (Circular E, Employer’s Tax Guide) and Publication 15-T (Federal Income Tax Withholding Methods) for use in the 2023 tax year.
Publication 15: This publication explains the tax responsibilities as an employer regarding the requirements for withholding, depositing, reporting, paying, and correcting employment taxes. The publication also explains the forms an employer must give to its employees, those employees must provide, and those the employer must send to the IRS and the Social Security Administration (SSA).
Publication 15-T: Publication 15-T supplements Publication 15 and Publication 51 (Agricultural Employer’s Tax Guide). It describes how to figure withholdings using the wage bracket method or percentage method.
Qualified sick/family leave in 2023: Publication 15 notes that the rate of Social Security tax on taxable wages, including qualified sick leave wages and qualified family leave wages paid in 2023 for leave taken between March 31, 2021 – October 1, 2021, is 6.2% each for the employer and employee or 12.4% for both.
However, qualified sick leave wages and qualified family leave wages paid in 2023 for leave taken between March 31, 2020 -April 1, 2021, are not subject to the employer share of Social Security tax; therefore, the tax rate on these wages is 6.2%. The 2023 Social Security wage base limit is $160,200.
Payroll research tax credit: For tax years beginning before January 1, 2023, a qualified small business may elect to claim up to $250,000 of its credit for increasing research activities as a payroll tax credit. The Inflation Reduction Act of 2022 (the IRA) increased the election amount to $500,000 for tax years beginning after December 31, 2022.
The election and determination of the credit amount that will be used against the employer’s payroll taxes are made on Form 6765 (Credit for Increasing Research Activities). The amount from Form 6765, line 44, must then be reported on Form 8974 (Qualified Small Business Payroll Tax Credit for Increasing Research Activities).
Starting in the first quarter of 2023, the payroll tax credit is first used to reduce the employer share of Social Security tax up to $250,000 per quarter and any remaining credit reduces the employer share of Medicare tax for the quarter (any remaining credit is carried forward to the next quarter).
Forms and publications discontinued forms after 2023: Form 941-SS (Employer’s Quarterly Federal Tax Return) and Publications 80 and 179.
Source: Thomson Reuters
by admin | Dec 20, 2022 | Blog
As many know, a Health Reimbursement Arrangement (HRA) is an employer-funded account that helps pay for a medical plan’s deductible and co-insurance expenses. There are three ways to access an HRA. Here they are as follows.
- Filing an electronic claim: this can be submitted by signing into your NueSynergy account.
- Filing a paper claim: a paper claim along with a copy of Explanation of Benefits (EOB) can be emailed to NueSnergy. A paper claim can be obtained by signing into your NueSynergy account or by calling NueSynergy’s customer service team (855-890-7239).
- Providing documentation: A copy of your EOB from your insurance company is required to approve any claim for reimbursement.
For more information on accessing HRA funds and about this account in general, check out this handout.
by admin | Dec 19, 2022 | Blog
Two months ago, NueSynergy wrote about several Health Reimbursement Arrangement (HRA) FAQs to keep in mind. Now, taking it a step further, NueSynergy will discuss what employers, specifically, should look for in regard to an HRA. Here it is as follows:
An HRA can be paired with any health plan with no limitations
This means that high-deductible health plans (HDHPs) are not required in order to offer this account.
What happens to the funds if my employee leaves the company?
HRA funds are not portable. Therefore, if any funds become unused then any remaining amount returns to you (employer).
An employer can only contribute funds to an HRA
This also means that owners and partners cannot participate in this account. Per IRS guidelines, anyone with two percent or more ownership in a schedule S corporation, LLC, LLP, sole proprietorship, or partnership may not participate. If you would like to provide an opportunity for your employee to save for additional medical expenses tax-free, then suggest them to enroll in a Flexible Spending Account (FSA).
As an employer, can I choose proration for new hires and family status change?
Yes. You can prorate contributions as long as it occurs throughout the year.
When does an HRA begin paying for an employee’s expenses?
An employer can either allow an HRA to pay before the employee meets any deductible, or it can be set up so that the employee has to meet a certain amount of out-of-pocket expenses before the HRA begins to pay.
