Final Notice of Benefit and Payment Parameters for 2020

Recently, the Department of Health and Human Services (HHS) released its final Notice of Benefit and Payment Parameters for 2020. This proposed rule describes benefit and payment parameters under the Affordable Care Act (ACA) that would be applicable for the 2020 benefit year. Standards included in the rule relate to:

  • Annual limitations on cost sharing
  • The individual mandate’s affordability exemption
  • Direct enrollment in the Exchanges
  • Special enrollment periods (SEP) in the Exchanges

HHS also sought comments on issues to address in the future, such as the practice of “silver loading,” the automatic re-enrollment process through the Exchanges and any additional measures that would reduce eligibility errors and potential government misspending. HHS noted that it intends to take the comments received in response to the proposed rule into consideration in future rule-making.

Notable Changes for 2020

The out-of-pocket maximum (OOPM) will increase, and the ACA’s affordability exemption threshold will decrease for 2020.

  • OOPM: $8,150 for self-only coverage and $16,300 for family coverage
  • Affordability threshold: 8.24% of household income

The final rule also enhances direct enrollment through the Exchanges and establishes a new SEP for the Exchanges. For more information on other changes, contact us today.

Wellness: How to Fuel a Workout

You have to put gas in your car to make it go, right? The same concept can be applied to your body and working out. You can’t expect your body to get you through a workout if it’s not properly fueled. Here’s what you should be eating before, during and after a workout for optimal results:

Before Your Workout

One hour before your workout, eat 1-4 grams of carbs per 2.2 pounds of your weight. Some examples of a good pre-workout snack include a piece of whole-grain toast with peanut butter and banana slices, fruit and Greek yogurt, or a peanut butter and banana protein smoothie. Finally, get hydrated before working out!

During Your Workout

If your workout lasts less than 45 minutes, you really only need to focus on replenishing the fluids you’re sweating out. If your workout is focused on endurance, consume 30-60 grams of carbs per hour to fuel your workout.

After Your Workout

What you eat after your workout is just as important as what you eat before. Make sure to consume 15-25 grams of protein within one hour of finishing your workout to replenish the nutrients lost in your muscles during exercise. Continue to hydrate and consume protein to help keep muscle soreness at bay. If you had a particularly intense workout, consider drinking water or sports drinks enriched with electrolytes to fully replenish your body.

Department of Labor Enforcement Actions Rise

U.S. Secretary of Labor Alexander Acosta recently said he “fully expects” Department of Labor enforcements to increase once new inspectors are trained. Acosta’s comments are consistent with the significant rise in enforcement actions employers have seen in recent years.

Increased DOL Enforcement Actions

In the 2016 fiscal year, OSHA conducted 31,948 inspections, and the EBSA recovered $352 million in enforcement actions. Compare that to the most recent data, where the EBSA recovered $1.1 billion. Despite the increased action, Department of Labor guidance on complying with rules and regulations has decreased.

What Does This Mean for Employers?

Employers should be aware that the uptick of enforcement actions will continue. Therefore, they should take action to assess their compliance responsibilities to avoid costly fines and penalties.

Similarly, companies should take time to become familiar with the newly proposed overtime rule to identify which employees may be affected if the rule becomes final.

Lowest Unemployment in Decades

Job numbers continued to rise in April, bringing unemployment to its lowest in 50 years, according to the Bureau of Labor Statistics.

Secondly, most job gains occurred in the health and business services fields, with strong growth in construction as well.

Job growth shows no signs of slowing down with over 150,000 jobs being added each month.

Experts warn to expect more modest job creation over the next few months, despite the upward trend.

Growth by the Numbers

Unemployment fell across all categories tracked by the BLS.

Notably, unemployment rates for women and Hispanics dropped to record lows for the first time since 1953 and 1973, respectively.

However, not all workers are feeling the economic gains. According to experts, long-term unemployment is still high, and the number of part-time workers looking to work full-time is steady.

Employer Takeaway

In conclusion, the job market is tightening up. Now is the time to attract talent and keep your current workforce.

Talk with us today to explore strategies for doing both.

Is it Time for Unlimited Time Off?
While more and more perks are about employee health, wellness, and happiness, they ultimately are also designed to keep workers at work. A recent article in Quartz at Work points out that more than anything, employees want more time off and out of the office. Unlimited time off, to be exact.

Vote on Health Care Won’t Come Until After 2020 Elections

President Donald Trump stated in a series of recent tweets that a vote on a Republican Party (GOP) replacement health care plan for the Affordable Care Act (ACA) won’t take place until after the 2020 elections.

GOP’s Health Care Plan

President Trump’s tweets stated that the ACA’s deductibles and premiums are “far too high” and that a replacement is needed. He continued to state that the GOP’s replacement plan for the ACA will have “far lower premiums (cost) [and] deductibles” and will be “much more usable.” He also affirmed that the GOP’s plan would support those with pre-existing conditions.

These tweets came one week after the president directed the Department of Justice (DOJ) to support a federal court ruling that the ACA is unconstitutional.

What does this mean for my organization?

While the recent developments may seem like major health care change is on the horizon, employers and employees can expect things to remain the same for the time being. You can expect that health care will be a hot topic on 2020 campaign platforms.

As such, all existing ACA provisions will continue to be applicable and enforced. Although the individual mandate penalty will be reduced to zero beginning in 2019, employers and individuals must continue to comply with all other applicable ACA requirements.

DOJ Supports Federal Court Ruling Invalidating the ACA

On Dec. 14, 2018, a federal judge ruled in Texas v. Azar that the entire Affordable Care Act (ACA) is invalid due to the elimination of the individual mandate penalty in 2019. In response, on March 25, 2019, the U.S. Department of Justice (DOJ) filed a letter with the 5th Circuit Court of Appeals agreeing with the lower court’s ruling. This means that the DOJ believes the lower court’s ruling should stand, and the ACA should be struck down as unconstitutional.

Following the ruling, however, the federal judge issued a stay and partial final judgment in the case. As a result, the ACA will remain in place pending appeal. The Department of Health and Human Services also confirmed that it will continue administering and enforcing all aspects of the ACA.

All briefs and responses in this appeal are due by mid-May 2019, and oral arguments will be scheduled shortly thereafter. Following oral arguments, a decision on the appeal will be issued. However, many industry experts anticipate that the Supreme Court will likely take up the case, which means that a final decision will not be made until that time.

While these appeals are pending, all existing ACA provisions will continue to be applicable and enforced. Employers and individuals must continue to comply with all other applicable ACA requirements. This ruling does not impact the 2019 Exchange enrollment, the ACA’s employer shared responsibility (pay or play) penalties and related reporting requirements, or any other applicable ACA requirement.