December 2014

In This Issue
• Happy Holidays from the NCMS Plan and MMIC Agency
• Understanding the Employer Shared Responsibility Mandate
• HSA Contribution Limits in 2015
• Ask George
• Help Your Employees Achieve a Healthy Weight in 2015
• Be a Healthy Host this Holiday Season

Happy Holidays from the NCMS Plan and MMIC Agency

One of the real joys this holiday season is the opportunity to say thank you and wish you the very best for the new year. We appreciate your loyalty and the loyalty of the hundreds of practices across the state that participate in the NCMS Plan.

May this season bring you the gifts of peace, hope and joy. We wish you continued success in the new year!

Pictured (L to R): Diane Irvine, Nancy Johnson, Gary Bossert, Aya Wallace, Barry Hill, Rachel Eaton, and George Fanelli


Understanding the Employer Shared Responsibility Mandate

Whether you manage a large practice or one that is growing, it's time to think about compliance with the ACA's employer shared responsibility (or "pay or play") mandate. The mandate was delayed last year...a relief to everyone...but now it's here and it is packed with deadlines, reporting requirements and details that could be confusing.

So, first off, who is impacted by the Employer Mandate?

• For employers with 50-99 full-time employees (including full-time equivalents), the mandate is delayed until 2016. These practices are still required to report on how many workers are covered in 2015. The delay, though, is only available to practices that did not make changes to their workforce or benefits (e.g. did not reduce workforce to get under 100, reduce overall hours to qualify for benefits from 2/9/14 to 12/31/14; or eliminate or reduce coverage from 2/9/14 to 12/31/14).

• Employers with 100 or more full-time employees will be required to provide health coverage to at least 70 percent of full-time employees in 2015. In 2016, these practices will be required to cover at least 95 percent.

• Practices with fewer than 50 employees are not subject to the Employer Mandate.

By 2016, all large practices will be required to comply with the Employer Mandate, which includes the following key provisions:

• Must offer coverage to full-time employees (those working an average of 30 hours or more per week).

• Coverage must meet minimum value (cover at least 60 percent of medical costs).

• Coverage must be affordable (employees' share of premiums cannot exceed 9.5 percent of the employee's wages).

Failure to comply with these requirements could result in hefty penalties. As a participating practice in the NCMS Plan, you already should be offering health insurance to all employees working at least 30 hours (or 24 hours) per week. Additionally, all NCMS Plan health products meet minimum value, covering at least 60% of medical costs. What only you will know is whether coverage is affordable based on the wages of your employees. If the premium deduction for an employee's individual coverage on your least expensive option does not exceed 9.5%, the coverage is deemed affordable. If coverage is not affordable, your practice could be subject to a penalty if the employee obtains coverage with a premium subsidy through the federal exchange.

The Employer Mandate can be confusing and this is only a brief summary. If you have questions or would like further information, please contact your NCMS Plan agent or our office at (800) 662-7917.


HSA Contribution Limits in 2015

Health Savings Account (HSA) contribution limits change slightly from year to year. According to the IRS, the HSA contribution limits in 2015 are $3,350 if an employee has individual coverage or $6,650 if they have family coverage. And if an employee is 55 or older, they can put in an additional $1,000 anytime during the year. Contributions are pretax if made through your practice or tax-deductible if an employee makes them on their own. Employees have until April 1, 2015, to make HSA contributions for 2014.

A Health Savings Account can be a valuable savings tool when paired with a qualified high deductible health plan. Contributions are sheltered from income taxes, the money grows tax-deferred, and the funds can be withdrawn tax-free for medical expenses. If you would like to learn more about HSAs and high deductible health plans, or have questions, contact your NCMS Plan agent or call us (800) 662-7917.


Ask George

Question: George, we recently switched our Health Savings Account (HSA) adminstrator from BenefitWallet (BW) to HealthEquity (HEQ). I'm confused about what will happen to the money in my employees' and physicians' BW HSAs when their HEQ HSAs are opened. Can you tell me how this will work?

Answer: You may recall in the last issue of CHOICES (Sept '14) we described the change in HSA administrators and how it will impact practices over the next few months. Your practice has the option of remaining with BW or working with HEQ going forward. However, the HSA balances that exist in BW HSAs will not transfer automatically over to the new HEQ HSAs. Each accountholder must act independently if they choose to transfer their balance. They may also choose to do nothing and spend down their BW balance while also depositing money into their new HEQ HSA. Their is no rule that prevents an accountholder from having more than one active HSA as long as combined contributions into either or both accounts do not exceed IRS limits.

When a new HEQ HSA is opened, employees receive a welcome kit that includes an HEQ debit card. Employees should not destroy their BW debit cards until after the BW account is closed or funds have been depleted or transferred. The BW debit card will still work and allow access to HSA funds in that account.

A member can transfer or rollover their HSA balance. For transfers, BW will process a member's request as a Trustee-to-Trustee transfer and send a check for them directly to HEQ. BW does charge a $25 check issuance fee for this service. The funds should be received and available within 3-6 weeks. No tax form will be issued by either party since the transaction is simply a balance transfer.

For rollovers, accountholders can only request one rollover every 12 months. A 1099-SA tax form will be issued by BW to report the distribution and a 5498-SA tax form will be issued by HEQ to report the rollover.

For more information and step-by-step instructions for initiating a transfer or rollover from a BW to HEQ HSA, review this Rollover/Transfer Guide. If you have additional questions about the transition from BenefitWallet to HealthEquity, contact me directly at (919) 878-7561 or


Help Your Employees Achieve a Healthy Weight in 2015

Is 2015 your year to lose weight & get fit? Look no further — Eat Smart, Move More, Weigh Less (ESMMWL) is the right program for you!

Effective upon your renewal August 1st, 2014 or after, the NCMS Plan provides coverage for ESMMWL, a 15-week online weight management program that promotes healthy eating and physical activity. ESMMWL is a preventive care benefit covered at no charge. To enhance the level of engagement, however, members will be required to pay a $30 fee at the time of registration that is returned upon significant completion of the program.

Members can access ESMMWL in an online interactive, real-time classroom format led by a credentialed Registered Dietitian. Members select the class that best suits their schedule – morning, lunchtime, and evening classes available. New 15-week series begin monthly, so there are plenty of opportunities to participate.

The NCMS Plan is committed to helping you realize the benefits of an effective health promotion program and equipping your employees with multiple strategies to eat, move, and live mindfully. We recognize that addressing weight management at the practice level can be a challenge. It’s a sensitive, far-reaching issue. Beyond effecting individual health and quality of life, obesity and obesity-related illnesses such as diabetes, heart disease, and even several cancers can lead to lower productivity and higher health care costs.

For additional details and to offer this program to your employees, contact Jason Horay directly at (919) 878-7560 or

Be a Healthy Host this Holiday Season

If you’re hosting this year’s holiday gathering or organizing your practice's holiday party, you have an advantage. You have the opportunity to serve great tasting healthful foods. Follow these tips for a happy (and healthy) holiday party:

• Use healthier substitutions when cooking and baking to save on fat and calories. Substitute nonfat or low-fat milk instead of whole milk. Choose low-fat cheese. Swap one egg with two egg whites. Mix in unsweetened applesauce instead of oil when baking. For more substitutions, check out Recipe Ingredient Substitutions.

• Serve a healthy version of a favorite holiday dish. Chances are, your guests won’t notice and you’ll feel great knowing you’re serving something healthier.

• Offer whole grains. Serve low-fat dip or low-fat cheese with whole grain crackers or bread. Add whole wheat rolls to your dinner menu instead of white rolls.

• Think fruits and vegetables. Serve fruits and veggies on appetizer trays. Try to include fruits and vegetables on at least half of your serving table to give you, and your guests, lots of great low calorie options to fill up on. Try unique vegetables like baby zucchini or edamame.

• Add some beans. Fiber fills you up faster and keeps you full. Serve a bean dip or mix beans into appetizers or salads.

• Cook up lean meats and fish. These are lower in fat and calories and offer a great alternative to heavier fare. Try shrimp, grilled or broiled salmon, roasted turkey breast, or lean roast beef.

• Make mini-desserts. Serve sweets in small baking cups or cut cakes and brownies into small bite-size pieces. Bake bite-size cookies. With smaller choices, guests can taste two or three desserts without getting stuffed or feel like they are missing out by only trying one slice of pie.

• Have low-calorie beverages on hand. Allow guests to choose from a variety of healthy options such as, diet soda, seltzer water, light beer, mineral water and coffee.

• Move around. Turn on some festive music and clear space for a dance floor. Tell your guests to bring a warm jacket for an after dinner stroll to see the holiday lights. Make it a game night with charades or Catch Phrase.


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