What the Biden Vaccine Mandate Means for Employers​

OSHA to Mandate Vaccine and Testing Temporary Standard for COVID-19​​

The 5th Annual Forsite Move Challenge

The 5th annual Forsite Move Challenge was completed on September 30th and the results are in! 

• 1st place: Team WBAY | 17,576 daily step average 
• 2nd place: Team Zepnick Solutions | 16,735 daily step average 
• 3rd place: Team Optima Machinery 14,823 daily step average 

48 Wisconsin teams stepped with us for CP, raising $10,650. $1,050 of those dollars were earned by the 21 teams that achieved above 10,000 daily steps. We continue to be humbled and grateful for our community, and the ability to come together and give back.

Agencies Plan Changes to Contraceptive Coverage Rules​

The Impact of Biden's Competition Executive Order on the Healthcare Industry.​​​​​

The American economy is finally recovering after more than a year of stagnation due to the COVID-19 pandemic. President Joe Biden’s administration wants to continue this momentum and further stimulate the economy. To help in that effort, President Biden recently signed an executive order aimed at increasing competition among businesses.

According to the White House, the order was designed to “promote competition in the American economy, which will lower prices for families, increase wages for workers, and promote innovation and even faster economic growth.”

The Biden administration notes that corporate consolidation has been accelerating for many years, leaving the majority of industries in the hands of only a few entities. The administration points to this trend as the main reason for slow wage growth and rising consumer prices. This latest executive order intends to reverse these effects.

All in all, the executive order includes 72 initiatives by more than a dozen federal agencies to help address competition inequality. 

Health Care Impact

The executive order addresses competition in health care in four main areas:

• Prescription drugs: The executive order directs the Food and Drug Administration to work with states and tribes to safely import prescription drugs from Canada, where drugs are less expensive. It also directs the Health and Human services (HHS) Administration to increase support for generic and biosimilar drugs. Additionally, the order encourages the FTC to ban "pay for delay" and similar agreements.
• Hearing aids: The executive order directs the HHS to consider issuing proposed rules within 120 days for allowing hearing aids to be sold over the counter. 
• Hospitals: The executive order directs the FTC to review and revise its merger guidelines to ensure hospital mergers do not harm patients. Additionally, the order directs the HHS to support existing hospital price transparency rules and finish implementing bipartisan federal legislation to address surprise hospital billing. 
  
• Health Insurance: The executive order directs the HHS to standardize plan options in the National health Insurance Marketplace so people can comparison shop more easily. Read more on knowing the cost of your healthcare before receiving it with the 2021 price transparency rule >>
  

Biden's Competition Executive Order Summary

The executive order broadly addresses competition inequalities across market sectors, with a significant focus on health care. These proposed initiatives have the potential to help individuals and small businesses alike. However, it remains to be seen how all of these initiatives will play out, as executive orders are essentially a directive to federal agencies to revise their regulations. Employers should continue to monitor exactly how the executive order plays out.

Preventing Turnover Post-Pandemic​

While turnover is a common occurrence throughout any given year, during the COVID-19 pandemic, turnover rates fell dramatically. Now, a significant number of employees are unwilling to return to the status quo that was established pre-pandemic. Because of this, experts predict a “turnover tsunami” coming in the latter half of 2021.

What Employees Want Post-pandemic

Generally, workplace survey data from the past year illuminates some commonalities between worker desires across industries. The following are some of the most coveted changes workers are looking for post-pandemic:

• Flexible work options
• Protection from burnout >>
  
• Competitive compensation
• Considerations for Employers

To stay ahead of these trends, employers will need to look inward toward their unique employee populations and determine what’s important to them. This inquiry may include surveying employees to learn about what they are looking for. To help meet the demands of a workforce, employers can consider implementing changes, such as:

• Providing remote or hybrid working arrangements
• Providing flexible scheduling options
• Adopting or expanding employee assistance programs to help with mental health and burnout
• Increasing compensation or bonuses

Having managers meet more frequently with employees to discuss challenges and concerns openly

Each organization is unique, and its employees may have varying opinions about what they value.

Read this article on addressing physical and mental health in the workplace >>

Proposed Rule Would Update Benefit and Payment Parameters for 2022​

On July 1, 2021, the Department of Health and Human Services (HHS) published a proposed rule that would revise several benefit and payment parameters under the ACA for the 2022 benefit year. While many of the proposed changes primarily impact insurers and Exchanges, some provisions may affect employers.

The rule proposes to repeal the Exchange direct enrollment option, which establishes a process for Exchanges to work directly with issuers, agents and brokers to operate enrollment websites through which consumers can apply for coverage, receive an eligibility determination and purchase a qualified health plan.

For the 2022 coverage year and beyond, the rule proposes to lengthen the annual open enrollment period for coverage through all Exchanges to Nov. 1 through Jan. 15. The current annual open enrollment period runs Nov. 1 through Dec. 15.

The rule proposes modifications to the Section 1332 State Innovation Waiver process, including changes to many of the policies and interpretations of the guardrails recently issued in the 2022 Notice of Benefit and Payment Parameters, which provided more flexibility for states to apply for waivers from certain ACA provisions.

Supreme Court Rejects Challenge to the ACA's Individual Mandate​​

On June 17, 2021, the U.S. Supreme Court rejected a lawsuit challenging the constitutionality of the Affordable Care Act’s (ACA) individual mandate in a 7-2 ruling.

This lawsuit was filed in 2018 by 18 states as a result of the 2017 tax reform law that eliminates the individual mandate penalty. In 2012, the U.S. Supreme Court upheld the ACA on the basis that the individual mandate is a valid tax. With the penalty’s elimination, the appeals court in this case determined that the individual mandate is no longer valid under the U.S. Constitution.

Supreme Court’s Ruling
The Supreme Court determined that the plaintiffs in this case did not have standing to sue, meaning that they have not shown that they suffered any injury as a result of the elimination of the individual mandate penalty and, therefore, do not have a legal right to sue. As a result, the ACA as it exists today will remain in place.

According to the Court, allowing a lawsuit "attack[ing] an unenforceable statutory provision [to continue] would allow a federal court to issue what would amount to 'an advisory opinion without the possibility of any judicial relief.'"

The Court did not make any determinations on any other issue in the case, including the validity of the individual mandate or whether the rest of the ACA can be severed from the individual mandate provision. However, this case is now concluded and the ACA will remain in place.

OSHA Updates Mitigation and Prevention Guidance for COVID-19​​​​​

On June 10, 2021, the Occupational Safety and Health Administration (OSHA) updated its guidance on mitigating and preventing the spread of COVID-19 in the workplace. The guidance applies to employers and employees in settings outside of the health care industry and is now focused only on protecting unvaccinated or otherwise at-risk employees in their workplaces.

The recommendations are advisory in nature, informational in content and intended to provide a safe and healthy workplace free from recognized hazards that are causing or likely to cause death or serious physical harm. 

Action Steps
Under the guidance, employers with unvaccinated or otherwise at-risk employees should update their COVID-19 prevention plans to provide policies and procedures for those specific employees to follow. Employers should also review the guidance for vaccinated employees working with unvaccinated employees and update their policies and procedures accordingly.

IRS Posts FAQs on ARP Tax Credit for Paid Sick and Family Leave​

On June 11, 2021, the IRS released new FAQs about tax credits for eligible employers who voluntarily provide paid employee leave under the Families First Coronavirus Response Act (FFCRA). The FFCRA paid sick and family leave requirements themselves expired Dec. 31, 2020, but subsequent legislation—most recently the American Rescue Plan Act (ARP)—extended and enhanced the tax credits available for employers that choose to provide FFCRA leave through Sept. 30, 2021.

The New FAQs
There are 123 new FAQs, divided into 16 subtopics. They include information on how employers may claim the tax credits, including how to file for and compute the applicable credit amounts and how to receive advance payments for and refunds of the credits. The FAQs clarify the following issues, among others:

• Daily and aggregate wage limits do not include health plan expenses or the employer’s share of Social Security and Medicaid taxes.
• Qualified leave wages do not include federal taxes on the wages.
• The last day an employer may file for advance payment of the credit.
• The credit may apply for leave between April and September 2021, even if the employer did not pay the employee initially.
• Employers must collect and maintain specific information from employees (and may require more than that specified) to substantiate eligibility for the credits. Records must be kept for six years.

Paid Sick and Family Leave Credits
The tax credits apply to employers with fewer than 500 employees and are refundable and advanceable. Wages are subject to daily and total limits.

What's In a Name? HR Action Steps for Employee Name Change​

With the summer wedding season underway, many employees may soon be changing their names. As a result, in the coming months, it is critical for employers to ensure that each employee's name is accurately reflected on required forms and internal records. Learn how to stay compliant in this video >>

IRS Issues Guidance on Taxability of DCAP Benefits for 2021 and 2022

On May 10, 2021, the Internal Revenue Service (IRS) released guidance >> on the taxability of dependent care assistance programs (DCAPs) for 2021 and 2022, clarifying that amounts attributable to previously issued carryover and extended grace period relief >> generally are not taxable.

Specifically, if these dependent care benefits would have been excluded from income if used during taxable year 2020 (or 2021, if applicable), these benefits will remain excludible from gross income and are not considered wages of the employee for 2021 and 2022. They will also generally not be taken into account for purposes of applying the exclusion limits of Internal Revenue Code Section 129.

​​IRS FAQs on COBRA Subsidies

The Internal Revenue Service (IRS) has published frequently asked questions (FAQs) on the application of the American Rescue Plan Act (ARP) subsidies for continuation health coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). The FAQs cover a wide range of topics.

Background

The ARP subsidy covers 100% of COBRA and State mini-COBRA premiums from April 1–Sept. 30, 2021, for certain Assistance Eligible Individuals whose work hours were reduced or whose employment was involuntarily terminated. The subsidy is funded via a tax credit provided to employers, insurers or group health plans, according to the terms of the statute.

Frequently Asked Questions

Among the topics covered are how to calculate and claim the tax credit, including when a third-party payer is involved. According to the guidance, employers must document individuals’ eligibility for COBRA premium assistance to claim the credit. The FAQs further clarify that:

• The subsidy is available for extended periods of COBRA coverage between April 1 and Sept. 30, 2021, due to a disability, second qualifying event or extension under State mini-COBRA.
• Involuntary termination includes constructive discharge and termination for cause, but not gross misconduct.
• Health reimbursement arrangements, dental-only plans and vision-only plans are covered by the subsidy.

Action Steps

Employers should review the IRS FAQs in their entirety to ensure compliance with the ARP, especially with respect to notice and documentation obligations.

Protecting Employees From Burnout​

Burnout has been a commonly discussed issue amid the COVID-19 pandemic. Oftentimes, it is the Human Resources department's responsibility to help employees cope with burnout and its contributing factors. 

Burnout, in simple terms, is the feeling of mental exhaustion stemming from workplace duties. According to the World Health Organization, burnout may be shown through the following symptoms:

• Fatigue or energy depletion
• Decreased engagement at work, or feelings of negativism or cynicism related to one's job
• Reduced productivity or efficacy
• As these examples show, burnout doesn’t always look the same for everyone. Yet, the impacts of burnout are typically uniform—lower-quality work and detrimental health effects.

4 Steps You Can Take to Help Your Team Recover From or Avoid Burnout Altogether

• Meet regularly with team members and peers to gauge their emotional states and discuss individual work duties as needed.

• Recognize and celebrate individual and team achievements.
• Train other managers on how to keep employees engaged and motivated at work, and how to spot signs of burnout.
• Clearly communicate that employees should reach out if they are experiencing burnout, and that there will be no punishment for seeking help.

Your team is made up of many unique individuals, each with different needs that should be met in order to recover from or avoid burnout. Consider what actions you can take as a team leader and mentor to meet their diverse needs and build up a supportive and productive workplace culture.

Hiring and Managing Seasonal Employees​

With the summer hiring season underway, employers should begin thinking about how best to hire and manage seasonal employees. Employers who do not dedicate time to these critical steps risk having to face disgruntled employees, unhappy customers, and even legal violations. 

To learn some best practices for hiring and managing seasonal employees, please watch this video >>>.

Read May's HR newsletter >> for 4 virtual recruitment strategies.

The Healthcare Transaction Process

It is important that you, as a healthcare consumer, feel confident in the accuracy of the payment you send to your provider after a healthcare visit. Healthcare reimbursement is a multi-step, lengthy and complicated process that could go a little something like this;

1.  A patient visits their healthcare provider for a particular service and checks in, presents their ID card and pays a copay fee if applicable.

2.  The patient receives care from their healthcare provider, who enters notes into an electronic file throughout the visit. These notes will later be used to create codes that the insurance carrier pays by.

3.  The patient’s visit is concluded and the patient leaves with no immediate bill or charge aside from a possible copay.

4.  The codes interpreted from your healthcare provider’s notes will be sent in an electronic data file to your insurance carrier, which will likely be automatically adjudicated and paid by the carrier. 

5.  The patient will receive their explanation of benefits (EOB) from the insurance carrier and an invoice from the doctor’s office if additional payment is needed.

The Explanation of Benefits

An explanation of benefits, or EOB, is a summary of your insurance benefits that have been applied to your medical claim. It is important to note that an explanation of benefits is NOT a final invoice and should not be treated as such. A crucial area of the patient’s EOB that should be examined is under ‘Member’s Responsibility’. The amount listed under ‘Member’s Responsibility’ should exactly match the amount due in the invoice from your doctor’s office. If the EOB and invoice amounts do not match, it is time to give your company’s Benefit Broker a call for assistance in resolving the claim discrepancy. 

EOBs should be filed and stored away for future reference. 

Asking for Help

When in doubt, contact your employer’s Benefits Broker for assistance resolving billing and claims discrepancies, help understanding your explanation of benefits or other insurance and billing related questions. For Forsite Benefits' clients, rely on our Forsite Assist team for benefit guidance. If you find your explanation of benefits does not match the doctor’s invoice, reach out to your doctor’s office for an itemized list of services and invoice coding to ensure coding is correct before finalizing a payment. 

Step 1: Establish an effective communication method with your employees.

A reliable communication method will ensure proper delivery of and engagement with important company updates and healthcare information. Perhaps company email, desktop messaging, or traditional paper notes into office mailboxes has been your communication practice over the years. With the overwhelming use of email today, desktop messaging only being accessible during office hours and traditional paper methods being less than reliable and un-trackable, these outdated communication methods rarely prove effective.

We find the best and most effective avenue to reach employees with important communications is through a device that never leaves their person; smart phones. Consider investing in a customizable smart phone app that would deliver notifications and text messages right to your employees’ phones.