ACA Reporting Draft Forms Now Available

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The IRS released draft 2018 forms for Affordable Care Act (ACA) reporting under Internal Revenue Code (Code) Sections 6055 and 6056. Draft instructions for 2018 have not yet been released.

The 2018 draft forms are substantially similar to the final 2017 versions. However, the revised version of the Form 1095-C clarifies that the “Plan Start Month” box in Part II will remain optional for 2018. The IRS previously indicated that this box may have been mandatory for the 2018 Form 1095-C.

Keep in mind that the 2018 draft instructions for these forms may include additional changes or clarifications, once released. Also, the IRS may make additional changes to these forms before releasing final 2018 versions.

Eligibility

Employers should become familiar with these forms for reporting for the 2018 calendar year. However, these forms are draft versions only, and should not be filed with the IRS or relied upon for filing.

  • 2018 draft Forms 1094-C and 1095-C were released July 11, 2018, and will be used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
  • 2018 draft Forms 1094-B and 1095-B were also released in July 2018, and will be used by entities reporting under Section 6055, including self-insured plan sponsors that are not ALEs.

Speak with Arista Consulting Group for more information.

Two HSA Bills Passed by the House

The House of Representatives passed two bills that have the potential to transform how health savings accounts (HSAs) are used. Despite passing in the House, the two bills need to be passed by the Senate in order for them to become laws.

What do the two bills propose?

H.R. 6199 (Restoring Access to Medication and Modernizing Health Savings Accounts Act), in addition to other changes, would reverse the ACA’s prohibition on using HSAs on over-the-counter health expenses.

H.R. 6311 (Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act), in addition to other changes, would allow certain individuals to use the ACA’s tax credit when buying low-premium Marketplace plans.

Please contact us for more information.

HBP Guidelines Have Changed: Do You Know Your Risk?

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Click Here to Access ARISTA’s September Wellness Calendar

The American Heart Association and the American College of Cardiology redefined what is considered high blood pressure (HBP) in November 2017, based on new evidence supporting a lower threshold. Stage 1 high blood pressure, also known as hypertension 1, is consistently measured at 130 over 80 or greater. The previous threshold was 140 over 90.

HBP is a serious condition that, if left untreated, can lead to coronary heart disease, heart failure, stroke, kidney failure and other health problems.

The New Guidelines & You

Under these new guidelines, nearly 46 percent of American adults are considered to have high blood pressure. Over one-third of Americans would be recommended for high blood pressure medication.

Your Next Steps

HBP is referred to as the “silent killer” because those who have it don’t typically experience symptoms. The best way to find out if you have HBP is to get your blood pressure checked every two years and speak with your doctor.

In some cases, HBP can be prevented by living a healthy lifestyle that includes exercising regularly, eating a healthy diet low in salt, fat and alcohol, avoiding smoking and managing stress.

For more information, speak with your doctor.

Fruits and Veggies: How Much is Enough?

If you’re like the majority of Americans, you’re most likely not eating enough fruits and vegetables. Fruits & Veggies – More Matters, a national health observance that occurs every September, wants to change that.

Fruits and vegetables contain essential vitamins, minerals, fiber and other naturally occurring substances that may help prevent chronic diseases.

How much is enough?

According to MyPlate, the U.S. Department of Agriculture’s symbol for healthy eating, the recommended adult daily serving for fruits and vegetables are:

  • Fruits
    • Women: 2 cups (ages 19-30), 1 ½ cups (ages 31+)
    • Men: 2 cups (ages 19+)
  • Vegetables
    • Women: 2 ½ cups (ages 19-50), 2 cups (ages 51+)
    • Men: 3 cups (ages 19-50), 2 ½ cups (ages 51+)

Healthy Recipe of the Month: Beets, Beans and Greens

¼ cup lemon juice

1 garlic clove (finely chopped)

2 tsp. mustard

2 tsp. vegetable oil

2 cups beets (cooked, sliced)

1 head of lettuce (washed, torn into pieces)

2 cups beans (cooked, rinsed)

Salt and pepper (to taste)

Preparations

Combine lemon juice, garlic, mustard, oil, salt and pepper in a large bowl to make a dressing.

Place sliced beets in a separate bowl. Toss 1 Tbsp. of dressing with beets to coat.

Toss the lettuce pieces and beans with the remaining dressing in the large bowl.

Plate dressed salad and beans. Add dressed beets on top.

Makes: 6 servings

HR Q&A: What is an HSA?

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Question: What is a Health Savings Account?

An HSA is a tax-advantaged trust or custodial account that eligible individuals can use to pay for (or reimburse themselves for) qualifying medical expenses. Unlike health reimbursement arrangements (HRAs) and health flexible spending accounts (FSAs), HSAs must be paired with high-deductible health plans (HDHPs). Also different from HRAs and health FSAs, the employee is the owner of the HSA, not the employer.

To be eligible to contribute to an HSA, an individual must be covered by a qualifying HDHP. In addition, the individual cannot be covered by any other health coverage (with some narrow exceptions), enrolled in Medicare or claimed as a dependent on another person’s tax return.

Both employers and employees are able to make HSA contributions; this is in contrast to an HRA where only employers can make contributions. An individual who contributes to his or her own HSA (separate from an employer) may take an above-the-line deduction for the contributions. Employers can also take a tax deduction for HSA contributions. If an employer sponsors a Section 125 plan (cafeteria plan), employee HSA contributions may be made on a pre-tax basis through the cafeteria plan.

HSAs are subject to maximum annual contribution amounts. The amounts vary depending on whether the individual has self-only or family HDHP coverage, and they are indexed annually by the IRS. Employees who receive employer contributions to their HSA must take this contribution amount into account when determining their own contribution, so as to not go over the IRS limit.

Individuals may use their HSAs to pay for (or reimburse themselves for) the qualified medical expenses of themselves, as well as their spouses’ and dependents’ qualifying medical expenses. Qualifying medical expenses are unreimbursed medical care expenses (as defined under Section 213(d) of the Internal Revenue Code) that are incurred after the HSA is established. HSAs are different from HRAs and health FSAs because they can be used to pay for non-medical expenses.

Howver, if HSA funds are used for purposes other than qualifying medical expenses, the amount used for those expenses is included in the owner’s income and is generally subject to an additional tax of 20 percent.

Also, as part of the health care reform law, over-the-counter medicine expenses (except insulin) cannot be reimbursed from an HSA unless they are prescribed.

At the end of the year, unused HSA funds roll over to the next year, which is not true for health FSAs.

HSAs are portable, meaning employees can maintain their HSA account and funds when they leave their jobs, and they do not forfeit any amounts upon retirement or termination of employment.

Prevent Heat Illness

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Click Here to Access ARISTA’s August Wellness Calendar

There were 7,415 heat-related deaths in the United States from 1999 to 2010, according to the Centers for Disease Control and Prevention (CDC). These preventable deaths illustrate how important preparation is during extreme temperatures. Whether you are swimming at the beach or lounging in the park, you should be prepared for extreme heat conditions.

Stay Prepared

The CDC provides three easy steps to prevent heat-related illnesses: stay cool, stay hydrated and stay informed. This summer, make sure you have shade wherever you are going and have attire, like a sun hat or a thin, long-sleeved shirt, to avoid direct contact with the sun. Be sure to drink lots of water—more than you usually do. Your body quickly loses fluids in the summer more quickly, which can lead to illness. Finally, stay informed by monitoring the local weather forecast and prepare accordingly for outdoor activities.

Know the Signs

The two most dangerous heat-related illnesses, besides dehydration, are heat exhaustion and heat stroke. Heat exhaustion is exhibited through cold, clammy skin, heavy sweating and nausea. If you or someone shows these symptoms, move to a cooler location and sip water. If you or someone has a rapid pulse, hot and red skin, and loses consciousness, this could mean heat stroke, and you should call 911 immediately. In this latter scenario, do not give fluids to the person showing the symptoms. Do, however, move them to a cooler location and lower their temperature with cool cloths.

Have a Responsible Summer

This Aug. 18 to Sept. 4, law enforcement will be stepping up their “Drive Sober or Get Pulled Over” campaign. This means police officers will be focused on spotting impaired drivers and pulling them over.

There were nearly 10,000 people killed in alcohol-impaired motor vehicle crashes in 2014, according to the CDC. This accounts for nearly 33 percent of all traffic-related deaths in the United States. Keep this sobering statistic in mind when attending gatherings with alcohol, like barbecues, beach parties or work events.

The National Highway Traffic Safety Administration (NHTSA) created a smartphone app to help drivers who cannot safely drive home. The app can help tell you where you are, help you call a taxi or help you call a friend. Other useful apps include Uber and Lyft, as both can get you home if it’s not safe for you to drive.

For more information on the Drive Sober or Get Pulled Over campaign, visit the NHTSA website.

Hepatitis C Rates Triple

The number of new hepatitis C infections has reached a 15-year high, tripling over the last five years, according to the Centers for Disease Control and Prevention (CDC).

New virus infections are increasing among young people ages 20 to 29. This is primarily due to more people using injection drugs, according to the CDC.

However, three-quarters of individuals living with hepatitis C are baby boomers (born between 1945 and 1965). They are six times more likely to be infected and to die as a result of the virus.

Hepatitis C shows few symptoms and nearly half the people infected are not aware of it. The most common transmission method is injection drug usage, but other ways include being unintentionally exposed in a health facility or transmission from mother to child.

Symptoms are mild or sometimes nonexistent for years. Since hepatitis C primarily affects the liver, dark urine, yellow skin or abdominal pain could be signs of infection. Talk to your doctor about your hepatitis C risk and ask if you should be tested.

Healthy Recipe of the Month: Broccoli Strawberry Orzo Salad!

¾ cup orzo pasta (uncooked)

2 cups fresh broccoli (chopped)

2 cups fresh strawberries (diced)

¼ cup sunflower seeds

Lemon Dressing:

1 Tbsp. lemon juice (fresh or bottled)

2 Tbsp. apple cider vinegar

2 Tbsp. olive oil

1 tsp. sugar (or honey)

Preparations

Cook pasta. Drain and rinse in cold water.

In a large bowl, combine orzo pasta, broccoli, strawberries and sunflower seeds.

For the lemon dressing, combine ingredients. Next, drizzle on top of the mixture in the other bowl.

Season with salt and pepper. Chill in refrigerator until ready to serve.

Makes: 6 servings

Association Health Plans Expansion

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The Department of Labor (DOL) recently released a final rule that gives small businesses more freedom to join as a single group to purchase health insurance in the large group market or to self-insure. These arrangements are called association health plans (AHPs).

By forming AHPs, small employers can avoid certain Affordable Care Act (ACA) reforms that apply to the small group market. According to the DOL, this will provide small employers with more affordable health insurance options.

However, in exchange for lower premiums, AHPs may cover fewer benefits. Most AHPs will not be subject to the ACA’s essential health benefits reform, which requires that small group plans cover a core set of items and services, like mental health care and newborn care.

Employer Considerations

Small employers may want to consider banding together to form an AHP as a more affordable health insurance option. Employers should carefully review the AHP’s benefit design to make sure it is appropriate for their workforce. Because AHPs are regulated at the federal and state level, the availability of these plans will also depend on a state’s regulatory approach.

Eligibility

The final rule allows employers to form an AHP together that is a single ERISA plan if either of the following requirements is satisfied:

  • The employers are in the same trade, industry, line of business or profession; or
  • The employers have a principal place of business within a region that does not exceed boundaries of the same state or the same metropolitan area.

Speak with Arista Consulting Group for more information.

Critical HIPAA Compliance Gaps Exposed by HHS

Over the last couple of years, the Department of Health and Human Services (HHS) conducted “desk audits” of 166 covered entities and 41 business associates.

These audits focused on select HIPAA privacy, security and breach notification requirements. HHS has not released its official findings from the audits yet, but it has identified serious compliance gaps in the following areas:

  • Security risk analysis
  • Security risk management
  • Right of access to protected health information (PHI)

Employers that sponsor group health plans should periodically review their compliance with HIPAA rules, including whether their security analysis and risk management for electronic PHI is up to date. Employers should also watch for more guidance from HHS on these compliance requirements.

Did You Know? 

Amazon announced it will be purchasing the online pharmacy PillPack. The deal is expected to close before the end of the year.

With PillPack, an online pharmacy startup that earned more than $100 million in revenue last year, Amazon is now able to enter the prescription market.

Other large mergers, like CVS-Aetna, indicate that industry giants are already trying to lower health care costs. Amazon’s latest acquisition will likely pressure the industry to continue that trend.

Stay tuned for more developments as new details emerge in the coming months.

WHO Calls for Ban on Artificial Trans Fats

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Click Here to Access ARISTA’s July Wellness Calendar

The World Health Organization (WHO) says that the artificially produced trans fats found in junk and fried foods contribute to more than 500,000 preventable deaths annually. That’s why the WHO has released REPLACE, a guide for governments to eliminate industrially produced trans fat in their countries. Their goal is to remove all artificially produced trans fats from the global food supply by 2023.

What exactly is trans fat?

Trans fat is vegetable fat that has been chemically altered by a process called hydrogenation. This process turns healthy fat into a solid, unhealthy fat that is worse for you than saturated fat. Trans fats boost low-density lipoprotein (LDL or bad cholesterol) levels and can increase your risk of heart disease by 21 percent.

What can you do to avoid eating and drinking trans fats?

The WHO’s campaign was launched mid-May 2018 and is in its early stages, which means it might take some time to see changes in the United States. In the meantime, you can read nutrition labels and look at the amount of saturated fat and trans fat per serving.

It’s also important to check the ingredient list, which is different from the nutritional label. Ingredient information is listed from greatest to smallest amounts, so if partially hydrogenated oils or high fructose corn syrup are listed as the first few ingredients, choose another product.

To learn more about trans fats and their health effects, click here.

Healthy Recipe of the Month: Lemon Velvet Supreme!

2 cups fat-free vanilla yogurt

3 Tbsp. instant lemon pudding mix

4 graham crackers (crushed)

½ cup mandarin orange slices (drained)

Preparations

1. Combine vanilla yogurt and pudding mix. Stir until combined.

2. Layer bottom of serving dish with crushed graham crackers.

3. Immediately pour pudding mixture over cracker crumbs.

4. Top with mandarin oranges.

Makes: 6 servings

ACA Affordability Percentages Will Increase for 2019

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The IRS recently issued a Revenue Procedure to index the contribution percentages used to determine the affordability of an employer’s plan under the Affordable Care Act (ACA).

These updated affordability percentages are effective for taxable years and plan years beginning Jan. 1, 2019. They represent a significant increase from the affordability contribution percentages for 2018.

As a result, some employers may have additional flexibility with respect to their employee contributions for 2019 to meet the adjusted percentage.

Affordable Coverage Test

For plan years beginning in 2019, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed:

  • 9.86 percent of the employee’s household income for the year, for purposes of both the pay or play rules and premium tax credit eligibility
  • 8.3 percent of the employee’s household income for the year, for purposes of an individual mandate exemption (adjusted under separate guidance)

This adjustment means that employer-sponsored coverage for the 2019 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 9.86 percent of the employee’s household income for the tax year.

The 2018 affordability percentage for the pay or play rules and premium tax credit eligibility was 9.56 percent. The 2018 percentage for the individual mandate exemption was 8.05 percent.

For more guidance on this and other compliance topics, contact Arista Consulting Group.

IRS Announces HSA Limits for 2019

The IRS recently announced that limits for HSA contributions will increase for 2019. The HDHP maximum out-of-pocket limits will also increase for 2019. The HSA contribution limits will increase effective Jan. 1, 2019, while the HDHP limits will increase effective for plan years beginning on or after Jan. 1, 2019.

HSA Contribution Limit

  • Family – $7,000
  • Single – $3,500

HDHP Maximum Out-of-pocket Expense Limit

  • Family – $13,500
  • Single – $6,750

Because the cost-sharing limits for HDHPs will change for 2019, employers that sponsor these plans may need to make plan design changes for plan years beginning in 2019.

Did You Know? 

The Trump administration unveiled an outline for potentially lowering the price of prescription drugs.

The blueprint identifies four key areas of focus:

1. Improved competition

2. Better negotiation

3. Incentives for lower list prices

4. Lowering out-of-pocket costs

Stay tuned for updates later in the year.

HR Q&A: Dental Benefits

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Question: Should your company offer dental benefits? Why?

It is relatively inexpensive to include dental benefits in an employer’s benefits plan, and it may help the employer attract and retain highly skilled employees.

Because dental hygiene is associated with overall health, employees with dental plans are often healthier. Employees without dental benefits may postpone or forgo dentist visits in order to save money, and as a result, they can end up with more severe health problems. This may cost an employer more in the long run than if dental benefits were offered.

Various types of dental plans are available. An employer should select one that fits its budget and meets the needs of its employees. Besides traditional dental insurance plans such as managed care and fee-for-service, consumer-driven dental plans—such as dental flexible spending accounts—are becoming more popular.

Employers who are concerned about the cost of offering dental benefits may consider sharing the cost with employees through deductibles, coinsurance and by setting maximum amounts that the company will pay per individual in a specific time period. When designing a dental insurance plan, aim for a plan that is cost-effective and valuable to the company and its employees.

The decision to offer dental benefits is a business decision. Employers should consider their cultures and values as an organization and whether such benefits can help attract and retain valued employees. While dental benefits are an added expense, offering these benefits may save the employer money over time.

Strawberries Named Dirtiest Produce for 3rd Year in a Row by EWG

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Click Here to Access ARISTA’s June Wellness Calendar

Every year, the Environmental Working Group (EWG) releases a Shopper’s Guide to Pesticides in Produce report that details which fruits and veggies are the least—and most—contaminated by pesticides. The guide is designed to help you make healthy and informed choices and reduce your exposure to toxic pesticides.

For the third year in a row, strawberries top the “Dirty Dozen” list of the most pesticide-tainted produce, with one-third of all conventional strawberry samples containing 10 or more pesticides. One sample even contained 22 pesticide residues.

The other fruits and vegetables on the Dirty Dozen list are: spinach, nectarines, apples, peaches, pears, celery, sweet bell peppers, grapes, cherries, tomatoes and potatoes.While pesticides boost crop yields, multiple studies have linked pesticides in produce to conditions like asthma, cancer, fertility issues and brain conditions. The Connecticut Agricultural Experiment Station recommends rinsing produce under water for 30 seconds to get rid of pesticide residues. For more information, visit EWG’s website.

Intermittent Fasting: What it is and Why People Are Doing it

Intermittent fasting is one of the latest health trends that has been gaining traction quickly. Intermittent fasting can look very different from person to person, but the two most popular approaches are:

  1. 5:2 approach: In this approach, you restrict your calorie consumption to 25 percent of your daily needs twice a week, and eat normally the remaining five days of the week.
  2. Eight-hour approach: In this approach, you fast for 16 hours a day, eating only during an eight-hour time period.

Studies have shown that intermittent fasting can have powerful benefits on your body and mind, and for weight control. Other studies state that it can also protect against Type 2 diabetes, heart disease and cancer.

As with any diet plan, it’s important to talk with your doctor before you start. For more information on intermittent fasting, or its benefits and drawbacks, click here.

Over 200 Rare Antibiotic resistant Genes Found in 27 States Report Shows

A Vital Signs report released by the Centers for Disease Control and Prevention (CDC) revealed that more than 200 rare antibiotic-resistant genes were found in bacteria tested in 2017.

According to CDC principal deputy director, Dr. Anne Schuchat, 2 million Americans get sick from antibiotic resistance, and 23,000 die from such infections each year.

The CDC is now promoting an aggressive containment strategy that includes rapid detection tests and screening for reducing the spread of antibiotic resistance. They also ask that you take simple preventive measures like washing your hands and getting vaccinated. For more information, click here.

How to Make Fried Rice

2 Tbsp. vegetable oil

3 cups brown rice (cooked)

1 carrot (cut into ¼-inch slices)

½ cup bell pepper (chopped)

½ cup onion (chopped)

½ cup broccoli (chopped)

2 Tbsp. low-sodium soy sauce

½ tsp. black pepper

1 tsp. garlic powder

2 medium eggs (beaten)

¾ cup chicken (cooked, chopped)

Preparations

  1. Heat oil in a large skillet over medium heat.
  2. Add rice and stir for 5 minutes.
  3. Stir in carrot, bell pepper, onion, broccoli, soy sauce, black pepper and garlic powder. Cook until vegetables are tender.
  4. Remove mixture from pan.
  5. Pour eggs into pan and scramble.
  6. Put vegetable mix and rice back in the pan and mix with scrambled eggs.
  7. Add chicken and cook until hot. Serve warm.

Makes: 6 servings