Upholding an Employer’s Reputation with Employee Safety Initiatives During the COVID-19 Pandemic

The COVID-19 (coronavirus) pandemic continues to validate the importance of an employer brand during a crisis. As employees return to the workplace, organizations must prioritize safety. If return-to-work plans go wrong and employee safety is not a top priority, not only will the health and safety of employees be at risk—but the organization’s reputation will be as well.

This article explores how safety impacts an employer’s brand, reputation and recruiting efforts—and how to transparently highlight safety measures taken to prevent the spread of COVID-19 in the workplace with current and prospective employees and the general public.

Why Safety Matters

The decisions that employers make about managing employees during the coronavirus pandemic will define their reputation for the next several years, so it’s critical to put some thought and planning into policies and communications. Now, more than ever, organizations will be judged not by their words, but by their actions.

Employers have a duty under the Occupational Safety and Health Act to provide a safe workplace. When developing safety plans, consider the following workplace safety measures to protect employees from COVID-19:

  • COVID-19 testing and contact tracing
  • Temperature screening
  • Social distancing
  • Personal protective equipment (PPE)
  • Personal hygiene and etiquette
  • Workplace cleaning and disinfecting
  • Paid time off and sick leave policies
  • Business travel guidelines

Taking these significant steps to ensure safety during the pandemic won’t be effective unless employees are aware of all of the efforts. Keep in mind that informed employees who feel safe at work are less likely to be unnecessarily absent. Lastly, it’s important that all employees are engaged and participating in companywide safety efforts. Effective communications will help achieve buy-in from employees.  

Employers should continue to monitor updates from federal agencies including OSHA and the Centers for Disease Control and Prevention, as well as guidance from local officials.

Employee Safety and Communication Efforts

An organization’s response to COVID-19 will impact their overall brand and image, along with their perception in the employment market during these challenging times. Proactive and effective safety efforts may help an organization recruit and retain employees during the pandemic and beyond.

Because the coronavirus pandemic has affected the lives of most people, it should be a core component of an employer’s brand. In addition, how an employer responds to the pandemic will affect their reputation. Reflect on how the organization has responded thus far to the pandemic and what tough choices have been made—and why. It’s vital to keep in mind the health, safety and well-being of employees when making business decisions.

At the forefront of concern for current and future employees is safety. The goal is to remain truthful and transparent. Consider these ways to help highlight COVID-19 safety efforts through employer branding efforts:

  • Establish a safety and health program. Creating initiatives or committees to address workplace safety and health can further document and promote desired behaviors. Organizations can publicly share general safety initiatives as well.
  • Provide usable and appropriate safety training or education. It’s important that employees understand and follow workplace controls like personal hygiene protocols and PPE usage.
  • Include safety-related expectations in job descriptions and postings. In the post-coronavirus employment market, a top concern for job-seekers is safety. Key messaging or FAQ documents may be helpful to ensure leadership or designated spokespeople understand and can deliver talking points for both internal and external audiences. Additionally, human resources and communications departments should maintain a consistent message.
  • Prioritize safety in employment-related company branding. Employers should consider updating their careers webpage to include attractive employee benefits like telecommuting, flexible work hours, staggered shifts and hazard pay.
  • Prioritize safety in nonemployment-related company branding. Employers should consider dedicating a section of their website or posting on organization social media to outline the organization’s response to the COVID-19 pandemic and highlight how employee health and safety is being prioritized. On these sites, employers can identify thought leadership opportunities, but should be prepared to publicly address any topics discussed if asked to do so.
  • Create a dialogue with vendors and partners. Employers should talk with business partners or customers about their response plans. Employers are encouraged to share best practices with other local businesses—especially those in their supply chain.

If an organization has taken significant steps to be adaptable and keep employees safe during this challenging time, those pandemic efforts are part of their brand story. Employers should communicate their evolving brand story to current and prospective employees and the general public, when appropriate.

Summary

The coronavirus pandemic offers a unique opportunity for employers to redefine their employer brand. Keep in mind that actions speak louder than words. So, put employees first, and lead with empathy, authenticity and transparency.

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.

National Cybersecurity Awareness Month 2020

October is National cybersecurity Awareness Month. During this annual event, government and industry leaders come together to raise awareness about the importance of cybersecurity.

This theme was selected to empower both individuals and organizations to take ownership of their unique role in promoting cybersecurity, with the key message being, “If you connect it, protect it.”

It’s crucial for businesses like yours to stay cyber-secure in order to safeguard company data, protect customers’ personal information and ensure employee privacy. Here’s how you can do your part to foster organizational cybersecurity:

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about more cybersecurity guidance and cyber insurance solutions, or need help with any form of insurance, please contact us at any time at 305.238.1000.

10 Tips to Maximize Productivity While Working Remotely

As a result of the COVID-19 pandemic, the stigma associated with working remotely has disappeared. And, as the pandemic continues, working from home is likely to stick around.

If you haven’t already, it’s important to assess how you’re doing working from home and whether you need to make adjustments. Distractions are all around, regardless of whether you are in the workplace or in the comfort of your home. Both work settings have their own set of productivity killers, and a lot can hinge on an employee’s personal ability to avoid distractions.

Common Distractions

Being efficient while working from home can be a challenge. It’s up to you to motivate yourself and be just as focused and effective as you would in the workplace. Keep in mind the following common distractions while working from home:

  • Roommates, family, friends and pets
  • Housework and chores
  • Emails, instant messages, phone calls and texts—whether work-related or personal
  • Social media and other online browsing
  • Entertainment, including television and radio

Distractions and home situations vary, so think about what or who else may be distracting you throughout the workday, and consider how to avoid those distractions during working hours.

Productivity Boosters

Being a productive remote worker comes with responsibility, self-reliance and resourcefulness. Set yourself up for success, and consider these tips to stay focused and efficient while working from home:

  1. Establish a designated workspace. It might be tempting to work from your couch or bed, but that could impact productivity and the ability to focus. Try to work from a consistent room, desk or chair so you can mentally enter work mode.
  2. Dress like you’re at work. Sticking to a routine and getting ready will trigger your brain that it’s time to work, giving you a little energy boost before you sit down.
  3. Plan working hours. Setting consistent hours keeps you accountable to yourself, your manager and your team. When planning your day, consider doing the highest priority tasks first and tackling the hardest work when you have the most energy.
  4. Set deadlines. Whether self-imposed or set by others on the team, focus on achieving the deadlines for your tasks. Think of it as a challenge and tackle it.
  5. Don’t multitask. Identify your most important tasks, and address them before the workday is over. Also, be aware of workplace stressors that trigger your time-wasting behaviors.
  6. Manage interruptions. It’s important to set boundaries with kids, pets and other roommates. It’s likely easier said than done, but try to encourage them to leave you alone during those designated work hours.
  7. Avoid chores. It’s easy to be tempted by dirty dishes or overflowing baskets of laundry. Save the housework for before or after the workday as switching gears between tasks can lower productivity.
  8. Take care of yourself. Get enough sleep, and consider dedicating some time for self-care, such as the time when you would otherwise have been commuting to and from the workplace. Start the day with something for yourself and, in turn, set yourself up for success.
  9. Separate work time and personal time. Try to stick to your workday schedule and log off as planned to prevent burnout. If available, don’t forget to take personal days—even if you are just staying at home.
  10. Check in with yourself. Without being in the workplace, it’s crucial to be self-aware. Take note of what you’re working on, how it’s going and how you’re feeling. This exercise may help you identify productivity problems so you can make a change for the better.

Overall, setting clear boundaries with both co-workers and anyone at home will help make the remote workday more focused and productive. If you’re feeling burnt out or often distracted while working remotely, talk to your supervisor or manager.

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.

Easing Employee Stress Surrounding Benefits During Uncertain Times

Employers are responsible for educating their employees about the health coverage options they offer. Now, amid massive uncertainty caused by events such as the COVID-19 pandemic, the upcoming presidential election and the impending court case over the constitutionality of the Affordable Care Act (ACA), employees may be more stressed than ever about the status of their employee benefits. That’s why it’s so critical to provide transparent and effective communication to employees about their benefits.

Talking to Employees About Stressful Current Events

Employees may be experiencing stress due to the uncertainty caused by the pandemic, the election and the status of the ACA. While you may not have all the answers, you can explain what’s going on and, if possible, how your organization is or will be responding. Consider the following talking points.

The COVID-19 Pandemic

By now, employees are likely familiar with how your organization is responding to the pandemic. Heading into the enrollment season, be sure to highlight any new benefits you’re adding to help support employees during these times, and provide clear communication about any changes you may be making to your plans. Continue to communicate your organization’s commitment to protecting employees’ health and safety, including notifying them of any crucial return-to-work plans.

The 2020 Presidential Election

As with past elections, health care is a top issue that incumbent President Donald Trump and Democratic presidential nominee Joe Biden are campaigning on for the upcoming 2020 election. While both are stating that they want to lower health care costs, each of their respective platforms could mean changes for Americans. As with any election, how and if these promises would be achieved once one of the candidates is in office remains to be seen.

As such, it’s important for you to learn more about where each candidate stands, so you can better understand and prepare for how this election could impact the employee benefits industry and your business. You can also encourage concerned employees to learn about each candidate’s platform so they feel informed about the situation. Reassure them that any changes to employee benefits resulting from the election will be communicated as they arise.

ACA Litigation

In late August 2020, the Supreme Court announced that it would hear arguments challenging the constitutionality of the ACA starting on Nov. 10, 2020. This will be the third time the Supreme Court has reviewed the ACA’s constitutionality. In 2012, the Supreme Court upheld the ACA on the basis that the individual mandate is a valid tax. In 2015, the Supreme Court upheld the constitutionality of the ACA’s health insurance Exchange subsidies.

On Sept. 18, 2020, U.S. Supreme Court Justice Ruth Bader Ginsburg passed away at the age of 87. If a new Supreme Court Justice is confirmed before the election, it could greatly impact the outcome of the upcoming litigation. It is widely expected that President Donald Trump’s nominee will have a more conservative viewpoint and would be more likely to invalidate the ACA. In contrast, a Supreme Court Justice nominated by Democratic Party candidate Joe Biden would be more likely to uphold the ACA. Until a nominee is ultimately confirmed, the practical impact of this decision remains to be seen. As a result, employers may want to closely monitor developments related to the Supreme Court nomination.

In addition, it’s important to note and communicate to employees that a verdict on the upcoming November case is not expected to come this year, but rather during the spring of 2021. You can also explain to employees that, while this legal challenge is pending, all existing ACA provisions will continue to be applicable and enforced. This challenge does not impact Exchange enrollment, the ACA’s employer shared responsibility (pay or play) penalties and related reporting requirements, or any other applicable ACA requirement.

Best Practices for Communication

In uncertain times such as these, employees are looking for guidance wherever they can find it. You can help calm some of their fears by taking the following actions:

  • Acknowledge fears and concerns, but also reassure employees of their value to the company and the company’s desire to keep them healthy, safe and supported.
  • Be open with employees about management decisions and ask for suggestions to rectify problems.
  • Provide as much information as possible about the pandemic, the election and the ACA litigation. Be sure to also provide information about how each of these may affect employees’ benefits, if applicable.
  • Highlight voluntary employee benefits that employees might not know about to help relieve financial stress or preserve their mental well-being.
  • Communicate the future of the business with employees often—in meetings, on the company intranet site, in newsletters and in blogs.

Most importantly, be empathetic in your communication, as each employee’s situation may be different.

For More Information

In these uncertain times, it’s imperative that you clearly communicate your business’s plans as frequently as circumstances allow. It’s not possible for you to control the pandemic, the election, the ACA court case or any other events that may have an effect on employee benefits. However, through effective communication, it is possible for you to ease the stress your employees are experiencing.

For additional employee communications or resources regarding employee benefits, contact Morris & Reynolds Insurance today. As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.

2021 Open Enrollment Checklist

To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2021. Employers should review their plan documents to confirm that they include these required changes.

In addition, any changes to a health plan’s benefits for the 2021 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM). Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, when applicable—for example, the summary of benefits and coverage (SBC). There are also some participant notices that must be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.

Links and Resources

Plan Design Changes

ACA Affordability Standard

Under the ACA’s employer shared responsibility rules, applicable large employers (ALEs) are required to offer affordable, minimum value health coverage to their full-time employees (and dependent children) or risk paying a penalty. These employer shared responsibility requirements are also known as the “employer mandate” or “pay or play” rules.

Under the ACA, an ALE’s health coverage is considered affordable if the employee’s required contribution to the plan does not exceed 9.5% of the employee’s household income for the taxable year (as adjusted each year). The adjusted percentage is 9.78% for 2020.

For plan years that begin on or after Jan. 1, 2021, the affordability percentage is 9.83%. This means that employer-sponsored coverage for the 2021 plan year will be considered affordable under the employer shared responsibility rules if the employee’s required contribution for self-only coverage does not exceed 9.83% of the employee’s household income for the tax year.

✓ If you are an ALE, confirm that at least one of the health plans offered to full-time employees (and their dependent children) satisfies the ACA’s affordability standard (9.83% for 2021 plan years). Because the affordability percentage increased from 2020 when it was 9.78%, employers may have additional flexibility in setting their employee contributions for 2021 to avoid a penalty under the pay or play rules.

Out-of-Pocket Maximum

Non-grandfathered health plans are subject to limits on cost sharing for essential health benefits (EHB). The annual limit on total enrollee cost sharing for EHB for plan years beginning on or after Jan. 1, 2021, is $8,550 for self-only coverage and $17,100 for family coverage.

✓ Review your plan’s out-of-pocket maximum to make sure it complies with the ACA’s limits for the 2021 plan year ($8,550 for self-only coverage and $17,100 for family coverage).

✓ If you have a high deductible health plan (HDHP) that is compatible with a health savings account (HSA), keep in mind that your plan’s out-of-pocket maximum must be lower than the ACA’s limit. For 2021 plan years, the out-of-pocket maximum limit for HDHPs is $7,000 for self-only coverage and $14,000 for family coverage.

✓ If your plan uses multiple service providers to administer benefits, confirm that the plan coordinates all claims for EHB across the plan’s service providers or divides the out-of-pocket maximum across the categories of benefits, with a combined limit that does not exceed the maximum for 2021.

Preventative Care Benefits

The ACA requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements (that is, deductibles, copayments or coinsurance) for the services. Health plans are required to adjust their first-dollar coverage of preventive care services based on the latest preventive care recommendations. If you have a non-grandfathered plan, you should confirm that your plan covers the latest recommended preventive care services without imposing any cost sharing.

More information on the recommended preventive care services is available through the U.S. Preventive Services Task Force and www.HealthCare.gov.

Health FSA Contributions

The ACA imposes a dollar limit on employees’ salary reduction contributions to a health flexible spending account (FSA) offered under a cafeteria plan. An employer may impose its own dollar limit on employees’ salary reduction contributions to a health FSA, as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year.

The ACA set the health FSA contribution limit at $2,500. For years after 2013, the dollar limit is indexed for cost-of-living adjustments. For 2020 plan years, the health FSA limit is $2,750. The IRS has not yet announced the health FSA limit for 2021 plan years.

✓ Watch for IRS guidance on the health FSA limit for 2021 plan years.

✓ Once the 2021 health FSA limit is announced, confirm that your health FSA will not allow employees to make pre-tax contributions in excess of that limit.

✓ Communicate the health FSA limit to employees as part of the open enrollment process.

HDHP and HSA Limits for 2021

If you offer an HDHP to your employees that is compatible with an HSA, you should confirm that the HDHP’s minimum deductible and out-of-pocket maximum comply with the 2021 limits. The IRS limits for HSA contributions and HDHP maximum out-of-pocket limit increase for 2021. The HSA contribution limits will increase effective Jan. 1, 2021, while the HDHP out-of-pocket limit will increase effective for plan years beginning on or after Jan. 1, 2021.

✓ Check whether your HDHP’s cost-sharing limits need to be adjusted for the 2021 limits.

✓ If you communicate the HSA contribution limits to employees as part of the enrollment process, these enrollment materials should be updated to reflect the increased limits that apply for 2021.

The following table contains the HDHP and HSA limits for 2021 as compared to 2020. It also includes the catch-up contribution limit that applies to HSA-eligible individuals who are age 55 or older, which is not adjusted for inflation and stays the same from year to year.

Additional HRA Design Options

Employers have two additional health reimbursement arrangement (HRA) design options for plan years that begin on or after Jan. 1, 2020—an individual coverage HRA (ICHRA) and an excepted benefit HRA (EBHRA).

✓ Review the additional HRA design options and decide whether to adopt either of these options for your employees (or a group of your employees).

✓ If you adopt an ICHRA for 2021, provide the required employee notice at least 90 days before the beginning of the plan year.

Wellness Plan Design – ADA Compliance

The Americans with Disabilities Act (ADA) applies to employer-sponsored wellness plans that ask for health information or include medical exams (for example, biometric testing). In May 2016, the Equal Employment Opportunity Commission (EEOC) issued final rules addressing the ADA’s requirements for employer-sponsored wellness programs. The final rules included a 30% limit for wellness incentives. A federal court vacated this incentive limit, effective Jan. 1, 2019. Consistent with this court ruling, the EEOC removed the incentive limit from its final wellness rules.

Due to the lack of guidance from the EEOC, it is currently unclear what level of incentive, if any, is permissible under the ADA for employer-sponsored wellness plans that ask for health information or include medical exams.

✓ If you sponsor a wellness program that asks for health information or includes medical exams, you should carefully review any incentive associated with the program (due to the lack of guidance from the EEOC).

✓ Watch for any developments related to the EEOC’s wellness rules.

✓ If the EEOC issues proposed wellness rules before the start of the 2021 plan year, review your wellness incentives and consider whether to make any adjustments.

ACA Disclosure Requirements

Summary of Benefits and Coverage

The ACA requires health plans and health insurance issuers to provide an SBC to applicants and enrollees to help them understand their coverage and make coverage decisions. Plans and issuers must provide the SBC to participants and beneficiaries who enroll or re-enroll during an open enrollment period. The SBC also must be provided to participants and beneficiaries who enroll other than through an open enrollment period (including those who are newly eligible for coverage and special enrollees).

On Nov. 8, 2019, the Departments of Labor (DOL) and Health and Human Services (HHS) issued an updated template and related materials for the SBC. These materials are required to be used for plan years beginning on or after Jan. 1, 2021. This means that the updated template must be used for the 2021 plan year’s open enrollment period.

✓ In connection with a plan’s 2021 open enrollment period, prepare to use the new SBC template and related materials. The SBC should be included with the plan’s application materials. If coverage automatically renews for current participants, the SBC must generally be provided no later than 30 days before the beginning of the new plan year.

✓ For self-funded plans, the plan administrator is responsible for providing the SBC. For insured plans, both the plan and the issuer are obligated to provide the SBC, although this obligation is satisfied for both parties if either one provides the SBC. Thus, if you have an insured plan, you should confirm that your health insurance issuer will assume responsibility for providing the SBCs.

Grandfathered Plan Notice

If you have a grandfathered plan, make sure to include information about the plan’s grandfathered status in plan materials describing the coverage under the plan, such as SPDs and open enrollment materials. Model language is available from the DOL.

Notice of Patient Protections

Under the ACA, non-grandfathered group health plans and issuers that require designation of a participating primary care provider must permit each participant, beneficiary and enrollee to designate any available participating primary care provider (including a pediatrician for children). Also, plans and issuers that provide obstetrical/gynecological care and require a designation of a participating primary care provider may not require preauthorization or referral for obstetrical/gynecological care.

If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of these patient protections whenever the SPD or similar description of benefits is provided to a participant. If your plan is subject to this notice requirement, you should confirm that it is included in the plan’s open enrollment materials. Model language is available from the DOL.

Other Notices

Group health plan sponsors should consider including the following enrollment and annual notices with the plan’s open enrollment materials.

Initial COBRA Notice

The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to employers with 20 or more employees that sponsor group health plans. Group health plan administrators must provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. The initial COBRA notice may be incorporated into the plan’s SPD. A model initial COBRA notice is available from the DOL.

Notice of HIPAA Special Enrollment Rights

At or prior to the time of enrollment, a group health plan must provide each eligible employee with a notice of his or her special enrollment rights under the Health Insurance Portability and Accountability Act (HIPAA). This notice may be included in the plan’s SPD.

Summary Plan Description

Plan administrators must provide an SPD to new participants within 90 days after plan coverage begins. Any changes that are made to the plan should be reflected in an updated SPD booklet or described to participants through an SMM. Also, an updated SPD must be furnished every five years if changes are made to SPD information or if the plan is amended. Otherwise, a new SPD must be provided every 10 years.

HIPAA Privacy Notice

The HIPAA Privacy Rule requires covered entities (including group health plans and issuers) to provide a Notice of Privacy Practices (or Privacy Notice) to each individual who is the subject of protected health information (PHI). Health plans are required to send the Privacy Notice at certain times, including to new enrollees at the time of enrollment. Also, at least once every three years, health plans must either redistribute the Privacy Notice or notify participants that the Privacy Notice is available and explain how to obtain a copy.

Self-insured health plans are required to maintain and provide their own Privacy Notices. Special rules, however, apply for fully insured plans. Under these rules, the health insurance issuer, and not the health plan itself, is primarily responsible for the Privacy Notice.

Special Rules for Fully Insured Plans: The plan sponsor of a fully insured health plan has limited responsibilities with respect to the Privacy Notice.

  • If the sponsor of a fully insured plan has access to PHI for plan administrative functions, it is required to maintain a Privacy Notice and to provide the notice upon request.
  • If the sponsor of a fully insured plan does not have access to PHI for plan administrative functions, it is not required to maintain or provide a Privacy Notice.

A plan sponsor’s access to enrollment information, summary health information and PHI that is released pursuant to a HIPAA authorization does not qualify as having access to PHI for plan administration purposes.

Model Privacy Notices are available through HHS.

Annual CHIPRA Notice

Group health plans covering residents in a state that provides a premium subsidy to low-income children and their families to help pay for employer-sponsored coverage must send an annual notice about the available assistance to all employees residing in that state. The DOL has provided a model notice.

WHCRA Notice

Plans and issuers must provide notice of participants’ rights to mastectomy-related benefits under the Women’s Health and Cancer Rights Act (WHCRA) at the time of enrollment and on an annual basis. Model language for this disclosure is available on the DOL’s website.

Medicare Part D Notices

Group health plan sponsors must provide a notice of creditable or non-creditable prescription drug coverage to Medicare Part D-eligible individuals who are covered by, or who apply for, prescription drug coverage under the health plan. This creditable coverage notice alerts the individuals as to whether or not their prescription drug coverage is at least as good as the Medicare Part D coverage. The notice generally must be provided at various times, including when an individual enrolls in the plan and each year before Oct. 15 (when the Medicare annual open enrollment period begins). Model notices are available on the Centers for Medicare and Medicaid Services’ website.

Summary Annual Report

Plan administrators who are required to file a Form 5500 must provide participants with a narrative summary of the information in the Form 5500, called a summary annual report (SAR). A model notice is available from the DOL.

Group health plans that are unfunded (that is, benefits are payable from the employer’s general assets and not through an insurance policy or trust) are not subject to the SAR requirement. The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file the Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period.

Michelle’s Law Notice

Group health plans that condition dependent eligibility on a child’s full-time student status must provide a notice of the requirements of Michelle’s Law in any materials describing a requirement for certifying student status for plan coverage. Under Michelle’s Law, a plan cannot terminate a child’s coverage for loss of full-time student status if the change in status is due to a medically necessary leave of absence. Due to the ACA’s age 26 mandate for dependent coverage, most health plans no longer condition dependent eligibility on full-time student status and, thus, are not subject to Michelle’s Law.

HIPAA Opt-out for Self-funded, Nonfederal Governmental Plans

Sponsors of self-funded, nonfederal governmental plans may opt out of certain federal mandates, such as the mental health parity requirements and the WHCRA coverage requirements. Under an opt-out election, the plan must provide a notice to enrollees regarding the election. The notice must be provided annually and at the time of enrollment. Model language for this notice is available for sponsors to use.

Wellness Program Notices

Group health plans that include wellness programs may be required to provide certain notices regarding the program’s design. As a general rule, these notices should be provided when the wellness program is communicated to employees and before employees provide any health-related information or undergo medical examinations.

HIPAA Wellness Program Notice—HIPAA imposes a notice requirement on health-contingent wellness programs that are offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (for example, not smoking) in order to obtain rewards. The notice must disclose the availability of a reasonable alternative standard to qualify for the reward (and, if applicable, the possibility of waiver of the otherwise applicable standard) in all plan materials describing the terms of a health-contingent wellness program. The DOL’s compliance assistance guide includes a model notice that can be used to satisfy this requirement.

ADA Wellness Program Notice—Employers with 15 or more employees are subject to the ADA. Wellness programs that include health-related questions or medical exams must comply with the ADA’s requirements, including an employee notice requirement. Employers must give participating employees a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared and for what purpose, the limits on disclosure and the way information will be kept confidential. The EEOC has provided a sample notice to help employers comply with this ADA requirement.

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.