September 2013

In This Issue
Notice to Inform Employees of Coverage Options
Employer "Play or Pay" Penalty Delayed
Voluntary Benefits with Colonial
Ask George
Hurry...Time is Running Out to Apply for a Practice Wellness Grant!
Upcoming Webinar: Impact of Health Care Reform on Workplace Wellness

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 information:

- 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.

All 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 Technical Release.

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.

The notice 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 the exchange.

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.

- Favorable underwriting guidelines not readily available in the traditional voluntary benefits market.

- Simple, personalized benefits communication and enrollment services for your core and voluntary benefit offerings through Colonial Life's electronic enrollment system.

- Personal, 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 employees.

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


Ask George

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


Hurry...Time is Running Out to Apply for a Practice Wellness Grant!

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 program.

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.

Time is 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 or 919.878.7530.

Remember, grant dollars are limited and applications are due October 31st, 2013, in order to ensure that funds are allocated to your practice.


Upcoming Webinar: Impact of Health Care Reform on Workplace Wellness

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 Workplace Wellness

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 physicians.

For more information about many other benefits of NCMS membership, visit