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Volume 11, Issue 3   September 2013
OUR MISSION
We’re passionate about — and strongly committed to — ensuring that individuals have access to quality coverage and benefits while maximizing employer savings.
 
DO YOU KNOW?
CONEXIS has a Participant Bill of Rights that helps us provide participants with the highest level of service. Find out more in our Behind the Scenes story.
 
CONTACT US
Have questions, comments, or feedback regarding the CONEXIS Comment Newsletter? If so, we would love to hear from you. Please drop us a line at comment@conexis.com.
 
 
COMPLIANCE CORNER
Defeat of DOMA Creates Continued Benefits Dilemmas
Since the U.S. Supreme Court ruled Section 3 of the Defense of Marriage Act (DOMA) and its limiting the definition of "spouse" to members of the opposite sex for federal purposes to be unconstitutional, lawyers and employers across the country have been scrambling. That’s because the court’s ruling affects the application of more than 1,000 federal laws, including laws that apply to the administration of employee benefit plans.
Complicating things even further is the fact that there are no clear-cut regulations on carrying out same-sex spouse rights, just various guidance from various departments on the topic. Recent announcements include:
  • A press release issued by the Internal Revenue Service (IRS) stating the U.S. Department of the Treasury and the IRS will recognize same-sex marriages for federal income tax purposes.
  • A press release from the Department of Health and Human Services (HHS). In it, HHS clarified that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouses live, including legally married same-sex couples.
  • An updated Family and Medical Leave Act (FMLA) Fact Sheet from the Department of Labor (DOL). The DOL declared it will determine who is a spouse based on the law of the state where the employee resides. This position is in keeping with current FMLA procedures.
As further guidance is still forthcoming, CONEXIS will continue to monitor developments and issue Compliance Updates when appropriate. Meanwhile, see our Compliance Flash and latest Compliance Update for more information, including helpful charts.
IRS Clarifies "Pay or Play" Postponement
Just as employers were gearing up to either "pay or play" — provide health care coverage to employees or pay a penalty — the Internal Revenue Service (IRS) issued additional guidance and delayed the mandate until 2015.
Notice 2013-45 clarified that the delay provides employers and other reporting entities more time for information reporting and employer-shared responsibility of minimum essential coverage. Two provisions required by the Affordable Care Act (ACA). But, the IRS emphasized, this transition relief is limited to the information reporting requirements and employer-shared responsibility payments. It is not intended to delay the "individual responsibility," nor any other provision of the ACA, including employees’ access to premium tax credit.
Beginning October 1, 2013, an employee can still enroll in qualified health plans through the Health Insurance Marketplace. To be eligible, the employee’s household income must be within a certain range and the employee is not eligible for other minimum essential coverage. This includes an eligible employer-sponsored health plan that’s affordable and meets minimum value requirements.
Health Insurance Marketplace Coverage Options Notice Reminder
The deadline for employers subject to Fair Labor Standards Act (FLSA) to provide a Health Insurance Marketplace Coverage Options Notice is fast approaching. In fact, it’s now only nine business days away.
As a reminder, the written notice to employees explaining their health coverage options through the Health Insurance Marketplace must be provided to current employees no later than October 1, 2013, and new employees within 14 days of their date of hire. In addition, all employees must receive this notice, regardless of plan enrollment status (if applicable) or part- or full-time status.
The U.S. Department of Labor (DOL) released Technical Release No. 2013-02 that provides additional guidance. Also available on the DOL website are two model notices employers may use.
NEWS AND TRENDS
Health Insurance Scams on the Rise
With confusion over health care reform provisions, there has been an increase in the number of health insurance scams across the nation. And, as open enrollment for the Health Insurance Marketplace draws near, the numbers are only increasing.
According to the Federal Trade Commission (FTC), scams arise any time there’s a change in government policy or a particular topic hits the news. In the case of the ACA, no sooner had the U.S. Supreme Court ruled on its legality in 2010 than scam artists began working their schemes.
Some scammers claim to be from the government, saying that under the ACA, they need to confirm some information (which isn’t so). Or, they need additional information to issue the person’s new "Obamacare card" (which doesn’t exist). Or, they can enroll the person in health insurance through the Health Insurance Marketplace before October 1, 2013 (which isn’t allowed).
If employees inform you of such scams, encourage them to contact the FTC at 877-FTC-HELP.
Please note: There are times when a CONEXIS client services representative, participant services representative, or benefits advisor will need to call to verify information. If ever unsure about a call from CONEXIS, we invite you and your participants to check it out with us. Simply get the representative’s or advisor’s name. Then send us a message through your online account, or call us using the contact number listed online.
Workers Declare Benefits Decisions Daunting
When it comes to employee readiness to take on more responsibility for their own health care choices, a new report says employees aren’t. The 2013 Aflac WorkForces Report (AWR), a national study that analyzes trends, attitudes, and use of employee benefits, found many individuals already find health insurance decisions daunting and have reservations about taking greater control.
According to the report:
  • 53 percent fear they may not adequately manage their coverage, leaving their families less protected than they are now.
  • 54 percent cite a lack of time and information to manage their coverage effectively.
  • 72 percent have never even heard the phrase "consumer driven health care."
  • 89 percent admit they tend to choose the same benefits every year with many not understanding the options provided to them.
What’s more, even though 53 percent of employers have introduced a high deductible health plan (HDHP) over the past three years, more than half of workers have done nothing to prepare for HDHP changes. For example, 62 percent of employees think their medical costs will rise, but only 23 percent are saving money for them.
That’s why many employers that offer a qualified HDHP are adding a health savings account (HSA) to their employee benefits package. HSAs can help employees cover eligible health care expenses today as well as in the future. Or, employees can save their HSA dollars for medical expenses they may have during retirement. Contact CONEXIS today to learn more.
Top Tips for Communicating Employee Benefits
Benefits communication done early, well, and often, aids employees’ understanding and use of their benefits. The result is employees (who use their benefits) tend to stay healthier, and healthier employees help keep costs down.
Here are three tips you can use for engaging employees in their benefits this coming year:
  1. Cut Through the Clutter.
    There’s a lot of news about health care reform right now, but most people haven’t followed closely enough to know what’s really going on. Help employees cut through the clutter. Share with them in simple language what the ACA is and how it affects, or doesn’t affect, their employee benefits. Then, refer them to healthcare.gov for more details. Do this in addition to the Coverage Options Notification employers are required to provide employees no later than October 1, 2013. It will ease employee apprehension and position the employer as a caring and trusted source of information.
  2. Say it Repeatedly.
    For a message to sink in, it has to be repeated. In fact, the more repetition, the better. This is where using both low- and high-tech options to spread the word is ideal, from face-to-face meetings and emails to blogs and other social media. Just remember to position the information as "What’s in it for me?" so employees will pay attention. Whether employee benefits are changing, or not, explain why this action is in their best interest.
  3. Provide Easy Access.
    For companies that use an intranet site for their benefits information or enrollment, make the site as easy as possible to access. Also, be sure to include the Web address of this site in all benefits communications.
Proposed Bill Discontinues FSA "Use it or Lose it" Rule
Fans and participants of flexible spending accounts (FSAs) may have reason to rejoice if some legislators have their way. There’s a bill that’s been introduced in Congress which would eliminate the "use it or lose it" rule.
H.R. 1634, the Medical FSA Improvement Act of 2013, would amend the Internal Revenue Code to allow employers to return FSA contributions that remain in an account to the participant as taxable income at the end of a plan year. Currently, under the "use it or lose it" rule, any unused funds are forfeited.
In a statement after introducing the bill, Rep. Charles Boustany, Jr., M.D. (R-LA), said approximately 35 million Americans rely on FSAs to help them pay for health care. Yet, one in four health FSA participants suffers forfeitures every year. He and other lawmakers want to see this changed so that FSAs are easier to use and more people are encouraged to enroll.
CONEXIS will continue to track this bill and keep you informed. To learn more about FSAs, visit our website.
BEHIND THE SCENES
Our Pledge to Participants
At CONEXIS, we strive to provide outstanding service to our clients and participants. One way we do this is by following the Participant Bill of Rights.
Developed by a group of CONEXIS participant services advocates (PSAs) and managers, the Bill lists 10 participants’ rights that we pledge to uphold. Rights that help us provide participants with the highest level of service.
"These are the same rights that we’d want and expect if we were participants," said Dee Dee Clough, assistant vice president of participant services. "By writing the rights down, training on them, and being accountable for them, we’ve come to embrace them. Now, we live and breathe advocacy of these rights day in and day out."
According to Dee Dee, an example of this is how our PSAs now do everything they possibly can for participants. "We no longer tell participants what we CAN’T do because of the rules and regulations of account-based plans or COBRA. We tell participants what we CAN do within these rules and regulations. There’s a big difference."
She explained the difference involves thinking outside the box frequently to provide participants with the answers or support needed. This may include offering a creative solution to employers through our client services department, when appropriate. "What’s exciting is 95 percent of our creative solutions presented to employers have been accepted. They know we only want to help their participants. So it’s wonderful when we work together to accomplish it."
For a copy of the Participant Bill of Rights, contact your CONEXIS representative.
Stepping Up for a Good Cause
Valerie Watson is always just a step away from a good cause. That’s because this senior manager within our client experience department uses her passion for running, interest in cooking, and love of animals to benefit others.
Valerie, a runner since a teenager, hits the pavement several times a year for organizations devoted to fighting heart disease, cancer, and more. "I try to find races that benefit causes I like to support," said Valerie. She also leads a team of CONEXIS employees on a three-mile, non-competitive walk through downtown Dallas each September for the American Heart Association’s Heart Walk® fundraiser. "It’s something near and dear to my heart because my mom passed away from a stroke and my family has a history of heart disease," she shared.
When Valerie’s not running for a cause, she’s helping to feed the hungry. She does this internationally, nationally, and locally. One group she supports is called Cooking Matters®, which teaches kids how to prepare healthy and affordable meals for themselves and their families. She also works at the local food bank where she enjoys showing up and helping wherever she can.
Her name is also linked to numerous animal shelters and organizations, including Don’t Forget to Feed Me, which provides pet food to pet owners in need. "It just feels good when I know I’ve helped someone, or a furry friend, in some way," said Valerie who definitely speaks from experience. She’s actively reunited 15 stray dogs with their owners and fostered two. She is currently a foster mom to a pit bull named Beau, who incidentally, has his own Facebook page. The page being just one of the many caring and resourceful ways that Valerie assists Beau, and other foster dogs to come, in finding their new forever homes.
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