|In This Issue|
||Notice to Inform Employees of Coverage
||Employer "Play or Pay" Penalty Delayed|
||Voluntary Benefits with Colonial|
||Hurry...Time is Running Out to Apply for a Practice
||Upcoming Webinar: Impact of Health Care Reform on
Notice to Inform Employees of Coverage Options
Employers are advised to distribute notices informing employees of the
existence of the health insurance exchange by October 1, 2013. However,
the Department of Labor (DOL) this week announced that it will not
penalize employers who do not provide the notice to employees.
Employers are advised to provide the notice to each new employee
at the time of hiring beginning October 1, 2013. The DOL will consider a
notice to be provided at the time of hiring if the notice is provided
within 14 days of an employee's start date. With respect to employees who
are current employees before October 1, 2013, employers are advised to
provide the notice no later than October 1, 2013.
This notice to
current employees and to new hires is required to include the following
- the existence of the health insurance exchange
- the potential for the employee to lose the employer's contribution
if coverage is purchased through the Exchange; and
- whether the
employer's plan meets the ACA's minimum value requirements.
current NCMS Plan health plans meet the minimum value requirement.
The NCMS Plan will not distribute this notice to practice
employees. The law indicates that employers should distribute this
information to their employees.
The DOL has made a model notice
available online in either pdf
or Word format.
For complete detail, read the DOL
The notification provision applies to
employers to which the Fair Labor Standards Act (FLSA) applies. In
general, the FLSA applies to employers that employ one or more employees
who are engaged in, or produce goods for interstate commerce. For most
firms, a test of not less than $500,000 in annual dollar volume of
business applies (i.e., the Act does not cover enterprises with less than
this amount of business). The FLSA also specifically covers the following
entities: hospitals; and federal, state and local government agencies.
In addition to model notices, the Department of Labor's Wage and
Hour Division provides guidance relating to the applicability of the FLSA
in general to include an online compliance assistance tool.
should be provided automatically, free of charge and in writing. It may be
provided by first-class mail or electronically. For practices who are
subject to COBRA and who use Ceridian's COBRA administrative services
through the NCMS Plan, Ceridian has revised their election notices to help
make qualified beneficiaries aware of other coverage options available in
For more information on the Affordable Care Act and
the NCMS Plan, review this Fact Sheet and watch our Health Care Reform webinar recorded on June 6, 2013.
Employer "Play or Pay" Penalty Delayed
On July 9, 2013, the U.S. Treasury Department and the Internal Revenue
Service ("IRS") issued formal guidance that provided for a one year delay
of the employer-mandated "play or pay" penalty under health care reform.
Employers with 50 or more employees now have an extra year- until 2015- to
provide affordable health care to all workers or face a penalty.
Health care reform requires employers with more than 50
full-time-equivalent employees to offer meaningful health coverage that
meets certain affordability requirements. If such coverage is not offered
and if an employee purchases subsidized health coverage through the health
insurance exchange, the employer is subject to a penalty, which could
accumulate to a potentially large amount.
The delay of the "play
or pay" penalty on employers does not impact the requirement for
individuals to purchase health coverage beginning 2014. Starting next
year, individuals must have and maintain health coverage or pay a
penalty amount on their tax returns. This potential penalty starts at $95,
or 1% of household income, whichever is higher, and goes up to $695 or
2.5% of household income starting in 2016.
Voluntary Benefits with Colonial
MMIC Agency, a subsidiary of Medical Mutual, is pleased to announce an
exciting new opportunity through our relationship with Colonial Life &
Accident Insurance Company.
MMIC Agency has marketed and serviced
the North Carolina Medical Society Employee Benefit Plan (NCMS Plan) for
medical practices since 1998. However, as health care costs continue to
rise, employees have had to incur more of the cost of healthcare or have
seen a reduction in benefits.
That's where voluntary benefits come
in. Voluntary benefits are the fastest-growing segment of the employee
benefits market. Employees need financial protection now more than ever.
Voluntary benefits enable employers to reduce their benefit costs and
still provide employees the coverage they need. Realizing this value, we
developed a relationship with Colonial Life to provide physician practices
such as yours some viable benefit solutions, for you and your employees.
Through this relationship, we can address potential existing gaps
in your benefit programs and provide benefits communication and enrollment
solutions. With Colonial Life's voluntary products and services,
you can now have:
- The ability to offer employees a broader, more
competitive benefits package at no direct cost to you. Your medical
practice can have access to Colonial Life's broad platform of quality life
insurance, disability insurance, accident insurance, specified disease
insurance for critical illness and cancer, and more.
underwriting guidelines not readily available in the traditional voluntary
- Simple, personalized benefits communication and
enrollment services for your core and voluntary benefit offerings through
Colonial Life's electronic enrollment system.
one-on-one benefits counseling sessions with each of your employees, to
help them better understand the benefits available to them, as well as
where they may need more protection for their individual situation.
- Flexible benefit offerings, tailored to each employee's
individual needs and budget.
We are excited to introduce this
exciting new relationship, and we look forward to meeting with your
practice to talk about the advantages it can provide you and your
To schedule an appointment with a representative or to
learn more, please
contact Barry Hill, Director of Sales and Marketing
at 919.878.7576 or email@example.com.
Question: We are a newly formed practice with 17 employees now
covered by the NCMS Plan. We have an individual who recently separated
from employment and has indicated that they want COBRA. We are not certain
of our responsibility and do not know how to proceed. Can you help?
Answer: You indicate that you have 17 employees enrolled in NCMS
Plan coverage, however, you may have more employees on your payroll. That
is an important point and will ultimately determine whether your practice
is subject to the federal COBRA program or state continuation.
Practices with 20 or more employees on more than 50 percent of its
typical business days in the previous calendar year are subject to COBRA.
Both full and part-time employees are counted to determine whether a plan
is subject to COBRA. Each part-time employee counts as a fraction of an
employee, with the fraction equal to the number of hours that the
part-time employee worked divided by the hours an employee must work to be
considered full time.
If in fact, based on the above description,
your practice is not subject to COBRA, then your practice would be subject
to the regulations governing NC State Continuation. Both COBRA and NC
State Continuation provide continuation of group health coverage that
otherwise would be terminated. Ultimately, it is up to the practice to
determine which applies.
Once your determination has been made,
the NCMS Plan can assist you appropriately. Either with COBRA and
administration of continuants at no charge to your practice through
Ceridian, or provide you with information from the NC Department of Insurance
regarding NC State Continuation as well as an election form that you can
relay to those in your group that are separating from employment.
If you have questions about COBRA or State Continuation, call me
at (919) 878-7561 or e-mail firstname.lastname@example.org.
Hurry...Time is Running Out to Apply for a Practice Wellness
The NCMS Plan has consistently promoted healthy lifestyle programs in
the workplace. We believe that healthy living - in and outside of the
workplace - leads to healthier employees and lower health care expenses.
One of the our most successful ways to begin to and further encourage
workplace wellness has been the Practice Wellness Grant Program which incentivizes
practices with grant money to implement and sustain a workplace wellness
In the past year, the Practice Wellness Grant Program has
seen a tremendous response with many success stories. With close to 100 participating
practices and almost 5,000 employees engaged, the Practice Wellness Grant
Program has allotted and awarded close to $500,000.
running out, though! In order to guarantee that funds are allotted to your
practice, an application must be submitted by October 31st, 2013.
Bear in mind that components of the program can be completed in 2014.
If you are interested in completing and submitting an application,
please contact Jason Horay at Jason.Horay@mmicnc.com or
Remember, grant dollars are limited and applications
are due October 31st, 2013, in order to ensure that funds are allocated to
Upcoming Webinar: Impact of Health Care Reform on Workplace
Don't miss the final Practice Wellness webinar of 2013. Mark your
calendar for October 24th and watch for an e-mail invitation soon.
The session is free to NCMS Plan practices; begins at 12pm, and lasts
20-35 minutes. All participants will be entered in a drawing for a $25
Amazon Gift card.
Health Care Reform and its Impact on
The changes resulting from health care
reform can be confusing - particularly as you prepare to assess the impact
it will have on wellness in the workplace. This webinar is designed to
help you understand how health care reform laws will effect your workplace
wellness program and will outline key considerations if your practice
offers wellness program incentives.
View the archive of previous webinars and a downloadable podcast
you can sync to your iPod.
About the North Carolina Medical Society
Established in 1849, the North Carolina Medical Society (NCMS) is
devoted to representing the interests of physicians and protecting the
quality of patient care as the largest physician organization in the
state. The NCMS Plan, sponsored by the NCMS, is the only statewide
employee benefits plan designed specifically for North Carolina
For more information about many other benefits of NCMS
membership, visit http://www.ncmedsoc.org/.