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Thursday, September 1, 2016
ProSential Group Partners Make the 2016 Inc. 5000 List

Tuesday, August 2, 2016
EEO-1 Pay Data Proposal

Wednesday, July 6, 2016
DOL Civil Penalty Fine Increase

Wednesday, June 15, 2016
New Resource Guide to Leave and Disability

Thursday, May 19, 2016
New Overtime Rule

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By ProSential Group on 9/1/2016 11:15 AM
We would like to acknowledge two ProSential Group Partners that were named on 2016’s Inc. 5000 List! A company’s appearance on this list means that they are among the top 5000 fastest-growing private companies in the country, and is a major accomplishment. We are extremely proud to work with these firms and look forward to seeing how they continue to grow.
By Peter Marathas, ProSential Compliance on 1/20/2016

On December 18, 2015, the President signed the Consolidated Appropriations Act, 2016 (CAA), which, among other changes to the Internal Revenue Code, permanently and retroactively restores parity by equalizing the limits for pre-tax parking and commuter benefits.

By Peter Marathas, ProSential Compliance on 1/19/2016
On December 16, 2015, the IRS released Notice 2015-87, which contains guidance on a broad range of topics under the Affordable Care Act (“ACA”), including:
By Peter Marathas, ProSential Compliance on 12/29/2015

On Monday, December 28th the Internal Revenue Service (IRS) announced it was delaying the 2016 Affordable Care Act reporting requirements. In Notice 2016-4 the IRS announced that the deadline for providing to individuals the 2015 Form 1095-B and Form 1095-C is delayed from February 1, 2016 to March 31, 2016

By Peter Marathas, ProSential Compliance on 12/18/2015

On Friday, December 18, the Senate voted to approve the Protecting Americans From Tax Hikes Act of 2015, which delays for two years the Affordable Care Act’s (ACA) excise tax on high cost employer-sponsored health coverage (the “Cadillac tax”). The bill also places a two-year moratorium on the ACA’s medical device tax and a one-year moratorium on the ACA’s annual fee on health insurers.

By Christopher Brown, ProSential Group on 3/19/2015 11:30 AM
The Department of Labor (DOL) has issued a final rule that defines how the term “Spouse” under FMLA applies to same-sex marriages.
By Peter Marathas, ProSential Compliance on 2/11/2015
Anthem Inc. (Anthem), the nation’s second-largest health insurer, revealed late on Wednesday, February 4 that it was the victim of a significant cyber attack exposing personal information of approximately 80 million individuals. This client alert discusses certain breach notification considerations the incident raises for employers, multiemployer health plans, and others responsible for employee health benefit programs under the Health Insurance Portability and Accountability Act (HIPAA) and state data breach notification laws.
By Peter Marathas, ProSential Compliance on 1/15/2015
Prior to the enactment of the Tax Increase Prevention Act of 2014 (“TIPA”) in December 2014, effective for 2014, mass transit commuters were only able to contribute a maximum of $130 per month on a pre-tax basis toward their transit expenses (a reduction from $245 per month permitted in 2013).
By Peter Marathas, ProSential Compliance on 11/6/2014
On November 4, 2014, the Internal Revenue Service (“IRS”) announced that it intends to close a perceived “loophole” in health care reform. This so-called loophole allows employers to offer low cost health plans that don’t cover inpatient hospitalization services or physician services (or both). If that coverage were treated as “minimum value” coverage, then employers could avoid all pay-or-play penalties with low cost coverage and covered individuals would not be able to benefit from premium assistance or subsidies in the health insurance Marketplace.
By Peter Marathas, ProSential Compliance on 9/23/2014

On Thursday, September 18, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-55, which expands the cafeteria plan “change in status” rules to allow plans to offer employees an option to revoke their elections for employer-sponsored health coverage to purchase a qualified health plan through a Health Insurance Marketplace (“Marketplace”). The notice is effective immediately and will appear in IRB 2014-41, to be published Oct. 6, 2014.

By Peter Marathas, ProSential Compliance on 8/6/2014

On July 24, 2014, the Internal Revenue Service (IRS) released three Revenue Procedures (2014-46, 2014-37, and 2014-41), which provide guidance to individuals on their obligation to maintain minimum essential coverage (MEC) under the Affordable Care Act’s (ACA) so-called “individual mandate.”

By Christopher Brown, ProSential Group on 8/4/2014 9:37 AM
The Equal Employment Opportunity Commission (EEOC) has recently issued new guidance on the Pregnancy Discrimination Act (PDA). The PDA was initially enacted in 1978, but has been somewhat neglected with the most recent formal guidance issued in 1983.
By Peter Marathas, ProSential Compliance on 7/23/2014

July 22, 2014 marked a day when two different federal courts came out on opposite sides of the same question. In the morning, the U.S. Court of Appeals for the DC Circuit dealt a serious blow to the Obama Administration with a decision that called into question the structural integrity of the “pay-or-play” mandates under the Affordable Care Act (“ACA”). Later in the day, the U.S. Court of Appeals for the Fourth Circuit, sitting down the road in Richmond, came out on the other side of the question.

By Peter Marathas, ProSential Compliance on 7/22/2014

The U.S. Court of Appeals for the DC Circuit has dealt a serious blow to the Obama Administration today with a decision that calls into question the structural integrity of the “pay-or-play” mandates under the Affordable Care Act (“ACA”).

By Christopher Brown, ProSential Group on 7/1/2014 2:28 PM
On Friday June 20, 2014, the Department of Labor (DOL) issued a notice of proposed rulemaking regarding the definition of “spouse’ under the Family and Medical Leave Act (FMLA).
By Christopher Brown, ProSential Group on 5/30/2014 2:29 PM
As small employers (those with less than 50 FTEs) continue to evaluate the impact of the Affordable Care Act (ACA), growing minorities of business owners are seeking the healthcare off-ramp. Many of these employers believe that they and their employees may simply be better off on plans offered through the marketplace, particularly if their employees may qualify for federal subsidies. Understandably, employers are also concerned that such a major shift in employee benefits could contribute to low morale or even outright hostility from their employees.
By Peter Marathas, ProSential Compliance on 5/16/2014

In April, the IRS released the 2015 inflation adjustments for Health Savings Accounts (HSA) and HSA-qualified high deductible health plans (HDHPs). A month earlier, HHS released details on the “premium adjustment percentage,” which is used to calculate annual increases in cost sharing under the Affordable Care Act’s (ACA) maximum out-of-pocket rules. These ACA rules limit participant cost-sharing under non-grandfathered group health plans for covered, in-network essential health benefits.

By Peter Marathas, ProSential Compliance on 5/9/2014

There has been much confusion and concern about the interplay between the COBRA continuation coverage rules and the new Health Insurance Marketplace established under the Affordable Care Act (the “Marketplace”). One important question has been how individuals could transition from COBRA continuation coverage to (often cheaper) Marketplace coverage. Also, many individuals are confused about whether they should continue their available COBRA continuation coverage or separately opt for coverage through the Marketplace. To help clarify the rules, the government agencies have issued some important new guidance.

By Peter Marathas, ProSential Compliance on 4/18/2014

Clients across the country have been approached by a variety of vendors claiming to have developed a “solution” for dealing with high cost participants. The particular names of the programs differ, as do some of the specific details, but in general these may be called “Affordable Access Plans,” “Affordable Care Plans,” “Alternative Care Plans” or something similar. Regardless of what they are called, these arrangements all promise employers a no-risk way to remove high claimants from their self-insured health plans, and move them over to the public exchanges. Is this a great idea, or what? From our perspective, “or what” would apply as would the old adage: “if it sounds too good to be true, it probably is.”

By Peter Marathas, ProSential Compliance on 4/16/2014

On March 28, 2014, the Internal Revenue Service’s (IRS) Office of Chief Counsel released two memoranda that provide guidance on certain administrative issues affecting employers that sponsor health flexible spending arrangements (health FSAs).

By Christopher Brown, ProSential Group on 4/8/2014 10:17 AM
On March 13th, the White House released a presidential memorandum directing the Department of Labor to revise and update regulations under the Fair Labor Standards Act (FLSA), particularly in regard to “white-collar” exemptions.
By Peter Marathas, ProSential Compliance on 4/3/2014
On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. The primary purpose of the law was to provide a one-year delay of a 24% reduction in payment rates for physicians who participate in the Medicare program.
By Peter Marathas, ProSential Compliance on 3/18/2014
On Thursday, February 27, 2014, the Centers for Medicare and Medicaid Services (“CMS”), released a letter to the Health Insurance Exchanges (“Exchanges”) enabling them to extend premium credits (i.e., federal subsidies) to individuals who were unable to enroll in qualified health plans (QHPs) through an Exchange due to technical difficulties with the Exchange’s automated eligibility and enrollment functionality. Individuals in these situations may have experienced “exceptional circumstances” and are afforded special relief—they may receive retroactive coverage and premium credits once they enroll in a QHP, or they may be eligible for premium credits for a QHP purchased outside of an Exchange in the individual market.
By Peter Marathas, ProSential Compliance on 3/6/2014
On February 10, 2014, the IRS released final regulations on the Affordable Care Act’s (ACA) employer “shared responsibility” provisions, also known as the “pay-or-play” mandate. The final regulations provide significant transition relief to “smaller” applicable large employers – i.e., those with 50-99 full-time employees, including full-time equivalents (FTEs). Prior to the final regulations’ release, employers that employed between 50 and 99 full-time equivalents were required to begin complying with the pay-or-play mandate in 2015, just like all other major employers. In the final regulations the IRS granted a brief but welcome reprieve to employers employing 50 to 99 FTEs. These small employers will not be subject to the pay-or-play rules until 2016.
By Christopher Brown, ProSential Group on 2/21/2014 4:09 PM
The U.S. Departments of Labor, Health and Human Services, and Treasury have recently issued proposed rules that would adjust regulations under the Health Insurance Portability and Accountability Act (HIPAA) regarding excepted benefits.
By Peter Marathas, ProSential Compliance on 2/21/2014
Federal Regulators (the Departments of Labor, Treasury, and Health and Human Services) announced yesterday, February 20, that they are releasing Final Regulations implementing the Affordable Care Act’s (ACA) 90-day limit on waiting periods for group health insurance coverage. The Final Regulations will be released in the Federal Register on Monday, February 24.
By Peter Marathas, ProSential Compliance on 2/17/2014
Employers who engage a significant number of 1099 employees run a tremendous risk of incurring the no insurance penalty, even when they offer coverage to all of the employees they categorize as full-time.
By Peter Marathas, ProSential Compliance on 2/10/2014
On Tuesday, February 10, 2014, the IRS released final regulations on the Affordable Care Act’s (ACA) employer “shared responsibility” provisions, also known as the “Play or Pay” mandate.
By Peter Marathas, ProSential Compliance on 1/29/2014
As previously reported, the federal agencies responsible for drafting the rules implementing the Affordable Care Act recently issued FAQ Part XVIII, regarding implementation of the market reform provisions of the ACA. Question 12 in FAQ Part XVIII includes guidance as to the effect of the ACA on the Mental Health Parity and Addiction Equity Act of 2008.
By Peter Marathas, ProSential Compliance on 1/23/2014
Part of the government’s efforts to provide so-called “subregulatory guidance” includes guidance for employers sponsoring wellness programs that contain tobacco cessation components, and on the “reasonable alternatives” required to be made available under health-contingent wellness programs.
By Peter Marathas, ProSential Compliance on 1/21/2014
The federal agencies responsible for drafting the rules implementing the Affordable Care Act issued FAQ Part XVIII regarding implementation of the market reform provisions of the Affordable Care Act, including new relaxed rules for fixed indemnity plans that meet certain key requirements.
By Peter Marathas, ProSential Compliance on 1/17/2014
On January 9, 2014, the Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) published the eighteenth installment of a series of answers to Frequently Asked Questions regarding implementation of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
By Christopher Brown, ProSential Group on 1/3/2014 3:13 PM
Although the “pay or play” penalty under the Affordable Care Act (ACA) was delayed until 2015, January 1st of 2014 still remains an important date for applicable large employers. This is particularly the case for employers that don’t currently sponsor a health plan or have a significant number of variable hour employee.
By Christopher Brown, ProSential Group on 11/26/2013 2:32 PM
On October 31st, the IRS issued Notice 2013-71 that further eroded the “use it or lose it” rule by allowing for a carryover of up to $500 of unused FSA benefits. The carried over funds do not count towards the new plan year’s statutory $2,500 limit.
By Christopher Brown, ProSential Group on 10/22/2013 8:26 AM
Title VII of the Civil Rights act of 1964 protects employees from discrimination on the basis of religion. Employers sometimes mistakenly believe that personal appearance policies can in effect override this protection, allowing them to impose requirements that may violate an employee’s religions tenants. In a recent case against Abercrombie & Fitch, a federal judge found clothing giant Abercrombie & Fitch liable for religious discrimination when it fired a Muslim employee for wearing her hijab (religious headscarf). The ruling came in an employment discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC).
By Christopher Brown, ProSential Group on 8/29/2013 11:37 AM
The practice of paying for benefits on a pre-tax basis has become so common that employers often forget that if done incorrectly, both employer and employee may face significant tax consequences.
By Christopher Brown, ProSential Group on 8/21/2013 8:21 AM
Have you heard this line? – To avoid penalties under the ACA, don’t let any of your part time employees ever work 30 or more hours per week!  If you have and it seems like a good strategy, this article isn’t for you. Rather, what we’ve heard from the vast majority of employers is that there is no practical way they could operate their business with such a hard arbitrary limit.
By Christopher Brown, ProSential Group on 7/11/2013 3:36 PM
Although changing job responsibilities may be relatively common in some firms, companies must always exercise caution when making such a change to the position of an employee with a disability. In a recent case brought by the U.S. Equal Employment Opportunity Commission (EEOC) against Luminant Mining Company LLC, a Dallas, Texas based coal mining company, the EEOC charged that the coal mine fired an equipment operator nine days after receiving information from a doctor indicating that he was disabled, and recommending an accommodation that the company could have easily granted.
By Christopher Brown, ProSential Group on 7/8/2013 9:02 AM
The recent Supreme Court Decision striking down key provisions of the Defense of Marriage Act (DOMA) has introduced new uncertainty for employers regarding the treatment of employees with same-sex spouses. The DOMA decision is particularly confusing because of complex issues relating to Federalism and the coordination between Federal and state law. Most Federal laws rely on state definitions of marriage. One of the unusual things about DOMA was the establishment of a Federal definition (or rather limitation) on what constituted marriage. Accordingly, once the Supreme Court issued its decision many Federal laws automatically reverted to their reliance upon state definitions of marriage.
By ProSential Group on 7/3/2013 8:36 AM
The Obama Administration announced Tuesday afternoon that it would delay the penalty and reporting provisions of the ACA’s employer mandate (also known as “Play or Pay”) until 2015. This was due in part to comments from interested parties concerned with the complexity of the proposed regulations amid looming implementation deadlines, and in part to the Administration’s desire to encourage employers to continue offering health insurance to their employees. Accordingly, both the employer and insurer reporting requirements and any penalties under the Play or Pay mandate have been delayed until 2015.
By Peter Marathas, ProSential Compliance on 6/26/2013
One part of an effective strategy for dealing with the affordable care requirements is to actually encourage employees on the bottom-end of the pay scale to not to take the coverage offered. This reduces the cost to the employer of offering affordable coverage, while still meeting the requirements of the federal law. Even if encouraging employees not take the insurance is not part of an employer’s strategy, allowing employees to elect potentially less-expensive alternatives to coverage may be something an employer wants to do.
By Christopher Brown, ProSential Group on 6/25/2013 12:55 PM
A South Carolina BMW facility and discount retailer Dollar General are being sued by the EEOC for disparate impact discrimination under Title VII of the Civil Rights Act. The EEOC claims that the two companies violated Title VII by implementing and utilizing a criminal background policy resulting in employees being fired and others being screened out for employment.
By Christopher Brown, ProSential Group on 6/3/2013 2:16 PM
On May 8, 2013 the Department of Labor issued the long awaited Model Notice to Employees of Coverage Options. The Affordable Care Act originally required that the notice be furnished to all employees covered by the Fair Labor Standards Act by March 1, 2013. However, on January 24, 2013 in “FAQs about Affordable Care Act Implementation (Part XI)” the DOL indicated that the notice requirement would not take effect on March 1, but be delayed until sometime in the “late summer or fall of 2013, which will coordinate with the open enrollment period for Exchanges.”
By Peter Marathas, ProSential Compliance on 6/3/2013
On May 29, 2013, the Departments of Health and Human Services, Labor and Treasury issued final regulations on implementing and expanding employment-based wellness programs.
By Christopher Brown, ProSential Group on 5/2/2013 8:00 AM
The Department of Labor (DOL) has recently issued an updated version of the Summary of Benefits and Coverage (SBC) template. The new SBC template, which was issued by the DOL on April 24, 2013, is effective for plans years beginning on or after January 1, 2014. Plan years beginning before January 1, 2014 may use the previously issued SBC template. The new SBC template is virtually identical to the previous version with two notable exceptions.
By Christopher Brown, ProSential Group on 4/23/2013 2:53 PM
A recent Family and Medical Leave Act (FMLA) case reinforces the need for firms to seek a clear picture of employment obligations associated with mergers and acquisitions.

In this case, an Atlanta based firm purchased an Arizona firm. An employee who began job protected leave under the FMLA prior to the acquisition was not reinstated by the acquiring firm when his FMLA leave ended. Ultimately the acquiring firm was found to be a successor employer and required to offer reinstatement, back pay and medical benefits to the employee who had been on leave.
By Christopher Brown, ProSential Group on 4/18/2013 1:19 PM
On March 8, 2013, the United States Citizenship and Immigration Services (USCIS) issued a new Form I-9, the previous version expired some time ago, but USCIS was greatly delayed in producing a new form. All employers in the United States are required to complete an I-9 for every newly hired employee.
By Peter Marathas, ProSential Compliance on 4/8/2013
Last month, Health and Human Services (HHS) released a proposed rule that delays part of the Small Employer Health Option Program (SHOP). Note that this delay does not change the effective date of the ACA’s employer “Play or Pay” mandate.
By Christopher Brown, ProSential Group on 4/5/2013 9:00 AM
On February 6, 2013, the U.S. Department of Labor (DOL) published a final rule to implement amendments to the Family and Medical Leave Act (FMLA) made by the National Defense Authorization Act for Fiscal Year 2010 (NDAA) and the Airline Flight Crew Technical Corrections Act (AFCTCA). The new rule was effective March 8, 2013.
By Peter Marathas, ProSential Compliance on 2/21/2013
There’s been a lot of buzz lately about increased efforts by federal agencies of their plan audit activities. Our lawyers across the country have seen a substantial uptick in activity from both the Department of Labor (DOL) and the Internal Revenue Service (IRS). Informal discussions in Washington, D.C. and regional offices have confirmed what we know anecdotally to be true: the federal agencies responsible for monitoring compliance of ERISA-governed plans are stepping up their audit efforts across the country.
By Peter Marathas, ProSential Compliance on 2/14/2013
Delaying the implementation of the Play or Pay Mandates by changing the plan year to a December 31 plan year so the plan won’t have to comply until December 31, 2014 is creative, but it won’t work.
By Tammy Gurowski on 11/5/2012 10:26 AM
We just attended a conference in Chicago with ProSential Partners and recognize that the ACA will change the marketplace. The challenge becomes how do we continue to demonstrate value, knowledge and deliver savings to our clients? How do we help control costs, educate employees, manage risk and streamline administrative efforts?
By Peter Marathas, ProSential Compliance on 10/16/2012
The number one question on the minds of business owners and managers across the country is exactly how much is it going to cost to implement the Patient Protection and Affordable Care Act (the “Act”). Uncertainty abounds. However, the one thing that is certain two years after its passage is that there is nothing affordable about the Act—at least not for employers and plan sponsors.
 

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