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HUMAN CAPITAL PRACTICE

                       HRFocus
                       May 2012 — Issue 59                          www.willis.com



HR CORNER
10 TIPS TO AVOID
A DOL WAGE & HOUR INVESTIGATION
Knock, knock … Surprise! Believe it or not, the federal Department
of Labor (DOL) does not require an investigator to previously
announce the scheduling of a wage & hour investigation. The
investigator has sufficient latitude to initiate unannounced wage &
hour investigations, in many cases, in order to directly observe
normal business operations and quickly develop factual information.
The following are some strategies to prevent this knock from
sounding at your company’s front door!

AVOID UNFAIR COMPENSATION PRACTICES
Make sure employees are compensated in a consistent manner. If an
employer’s pay practices are consistent, complaints are less likely to
arise, and the employer will be in a better situation if DOL does
                                                                                TABLE OF CONTENTS
launch a wage & hour investigation.
                                                                                HR CORNER
UNDERSTAND THE REGULATIONS                                                      10 Tips To Avoid A DOL Wage
It is important that employers take the time and make a concerted               & Hour Investigation                   1
effort to understand and familiarize themselves with the Fair Labor
                                                                                HR Metrics: 10 Ways To Assess
Standards Act (FLSA). It is the law, and if employers fail to follow the
                                                                                Strategic Business Context Of
law they may face litigation or a DOL audit.                                    Your Organization                     2
                                                                                LEGAL & COMPLIANCE
TRAINING
Train managers so they are fluent in the language of the FLSA.                  ERRP Funds Exhausted                  3
                                                                                FAQS On How HHS Will Define
ANALYZE STATE VERSUS FEDERAL LAW                                                Essential Health Benefits             4
Determine whether the state’s wage & hour laws conflict with federal            Maryland Allows Same-Sex Marriage     5
law, then follow the law that is most beneficial to the employee.
                                                                                San Francisco: HCSO Annual
                                                                                Reporting Form Now Available          6
PAY PAST OVERTIME DUE                                                           CHIP Model Notice Revised             6
If it is determined that an employee is wrongly classified as exempt,
the employer should determine how many overtime hours the                       SINCE YOU ASKED
employee has worked in the past 2 years, then pay the employee the              HSA Contribution Limits:
overtime due. The employer should also have the employee sign a                 Account Holders, Spouses And Adult,
release to free the employer from further liability. Paying past                Non-Dependent Children                7
overtime due to employees now will be far less expensive than paying            WELLNESS
them in a DOL settlement.                                                       Assessing The Health Of
                                                                                Your Population                       9
FOLLOW CHILD LABOR LAWS                                                         WEBCASTS                              11
Employers must determine a minor’s age and set his or her job duties
and work schedules accordingly and carefully. Also, employers must              CONTACTS                              12
file the minor employee’s age certificate, keeping it for as
long as the minor is employed.                                     HR METRICS: 10 WAYS
                                                                   TO ASSESS STRATEGIC
PAY YOUR INTERNS, UNLESS THEY MEET A STRICT TEST
Internships in the for-profit, private sector will most often      BUSINESS CONTEXT OF
be viewed as employment by the DOL, unless a strict test is
met. Interns who qualify as employees rather than trainees
                                                                   YOUR ORGANIZATION
typically must be paid at least the minimum wage and
                                                                   HR metrics are the key for HR professionals to be
overtime compensation for hours worked over 40 in a
                                                                   active participants in a business’ strategic decisions.
workweek.
                                                                   HR metrics provide the means for HR professionals
                                                                   to communicate with management. However,
RESPOND TO INTERNAL COMPLAINTS EXPEDITIOUSLY                       typically, busy HR leaders can spend only 10 percent of
If an employee files a wage & hour complaint internally, the       their time at the strategic level, and only 2 in 10 have a
employer should take it seriously. Since many                      process in place for measuring the business
investigations are prompted by an employee’s complaint,            performance of employees. These numbers indicate
employers might be able to prevent an investigation by             that success is not being measured as well as it should
addressing an employee’s initial internal complaint.               be, which can ultimately keep HR from being the key
                                                                   contributor to organizational success that it could be.
SEEK COMPLIANCE ASSISTANCE FROM DOL                                In a BLR webinar titled “HR Metrics: How to Measure
Various compliance tools and information are available on          and Communicate Your Strategic Value in Bottom-
DOL's website.                                                     Line Terms,” Ronald Adler and Jennifer Burdick
                                                                   outlined how the use of HR metrics allows HR
CONDUCT A SELF-AUDIT                                               professionals to tell their story effectively.
Employers can hire attorneys to audit their companies—or
they can do it themselves before DOL initiates an                  HR METRICS: TELLING YOUR STORY
investigation. Conducting a self-audit helps ensure                HR Metrics are about telling a story about your
compliance with federal and state laws. As part of an audit,       organization. Like other stories, your story:
employers should:
                                                                       Must have context
    Review job descriptions to determine whether they are              Should consider historical information (lagging
    still accurate, reflect the jobs being performed, and               indicators)
    reflect the skills necessary to perform the job.                    Should report current information (coincident
    Review employees’ actual job duties to ensure that they            indicators)
    still fall within the administrative, executive,                   Should indicate possible future events (leading
    professional, computer, or outside sales exemptions.               indicators and predictive analytics)
    Make sure overtime for nonexempt employees has                     Should consider its audience (there is a growing
    been properly calculated                                           list of internal and external stakeholders and users
    Make sure the required posters have been hung in the               of HR metrics)
    appropriate places in the workplace.                               Should engage the audience and motivate action

DOL investigators look for complete, accurate, and                 What stories do your metrics tell about your
unambiguous pay records for every employee for each pay            organization’s human capital and HR management?
period from the past 3 years. As a result, it is imperative        Are your executives listening?
that employers strive to keep accurate, well-organized wage
& hour records that can be produced quickly. If violations
are found, the employer may owe back pay, face penalties,
and be advised by DOL to make changes in employment
practices in order to avoid future violations.

This article provided by BLR.


                                                               2                                    Willis North America • 05/12
HR METRICS: STRATEGIC BUSINESS CONTEXT
The starting point in developing the right metrics to effectively tell your story is to fully understand
the strategic business context you’re working in. Here are 10 areas to assess in order to understand
the strategic business context of your organization:

    How does your organization produce revenue?
    How does human resources add value to your organization?
    Are HR activities and employment practices aligned with your organization’s strategic and
    business goals and objectives? How do human resources impact these objectives?
    What are your organization’s key business measurements and metrics currently? How does your
    organization measure success? What’s on your organization’s scorecard? Adler noted that this is
    a starting point for your whole discussion.
    How do human resources impact your organization’s key business measurements and metrics?
    What are your organization’s business imperatives, i.e., what distinguishes your organization in
    the marketplace? How do HR activities and employment practices impact these imperatives?
    What are your organization’s risks and opportunities? How do HR activities and employment
    practices impact these risks?
    What decisions do you want to influence?
    Can you connect the dots between the metric and decision making?
    What happens if your organization misses the target?

By understanding these 10 areas, you can begin to best understand what HR metrics will be most
useful to develop and which will best tell your story to the organization’s leaders.

This article provided by BLR.



LEGAL & COMPLIANCE
ERRP FUNDS EXHAUSTED
On February 17, 2012, the Early Retiree Reinsurance Program (ERRP) announced that requests for
reimbursement had exceeded the $5 billion funding allocated to the program. Reimbursement
requests which exceed the program's $5 billion will now be held in the order of receipt, pending the
availability of funds. Plan sponsors with reimbursement requests on hold can expect to receive an
email notifying them that their reimbursement requests have been placed on hold pending the
availability of funds. Plan sponsors who have received such an email can call the ERRP Contact
Center to obtain updated information on the position of the reimbursement request in the list of held
reimbursement requests.

The Centers for Medicare & Medicaid Services (CMS) has indicated it will continue to pay
reimbursement requests in the order received until available funds are exhausted. If there are not
sufficient funds to pay in its entirety the first reimbursement request that causes the initial
exhaustion of the funds available for payment, CMS will partially honor that reimbursement request,
and will pay the balance of that reimbursement request if additional funds become available through
overpayment recoupment efforts. In the event that funds become available as a result of overpayment
collections, CMS will pay subsequent reimbursement requests in the order of receipt until funds are
once again exhausted.

Related to ongoing ERRP requirements, CMS has announced its expectation that plan sponsors will
use ERRP reimbursement funds they have received, or will receive, as soon as possible, but in no case
later than December 31, 2014. Plan sponsors can view the Common Question on this topic, 800-13,
which is posted in the "Use of Reimbursement" section of the Common Questions on www.errp.gov.

                                                           3                                       Willis North America • 05/12
BACKGROUND
The ERRP was established by the health care reform law with appropriated funding of $5
billion. It became effective June 1, 2010. The program provides reimbursement to plan
sponsors of participating employment-based plans for a portion of the cost of health
benefits for early retirees and their spouses, surviving spouses and dependents. In order to
obtain reimbursement under the ERRP, plan sponsors had to first submit a completed
application to the Department of Health and Human Services (HHS) and be accepted into
the program. HHS began accepting ERRP applications on June 29, 2010 but stopped
accepting them in May 2011. The program was slated to end no later than January 1, 2014,
but HHS had the authority to stop taking ERRP applications based on the availability of
funding.

Once a plan sponsor’s ERRP application was accepted, the plan sponsor could submit
documentation of actual costs for early retiree health care benefits and receive
reimbursement from the ERRP. Claim reimbursements began in October 2010. In
December 2011, ERRP announced that reimbursements would be unavailable for claims
incurred after December 31, 2011.

For more information on the ERRP, see Willis Human Capital Practice Alert, Vol. 3, No. 7,
“It’s a Start: Guidance on the Early Retiree Reinsurance Program.”


FAQS ON HOW HHS WILL DEFINE ESSENTIAL
HEALTH BENEFITS
The Department of Health and Human Services (HHS) has added a set of FAQs to its
previous releases on the approach it intends to follow in defining “essential health benefits”
(EHB).

NOTE: The health care reform law directs the relevant agencies to define EHB so that a plan
providing EHB will be similar in scope to typical employer-provided health benefits and will
include coverage in 10 broad categories of health care. HHS has indicated that it intends to
issue regulations under which each state chooses a benchmark plan from among several
options and then determines what must be added so that the resulting plan provides
coverage of all 10 categories of health care that the statute specifies for EHB. This means
that there will be multiple state-specific definitions of EHB, rather than a single definition.

The new FAQs primarily provide details on how HHS will work with states to define EHB.
They also include, however, information on how an employer would use the EHB definition in
complying with the lifetime and annual dollar limits provisions of the health care reform law.

WHY THE EHB DEFINITION MATTERS TO EMPLOYERS SPONSORING HEALTH PLANS
Employers generally are not responsible for ensuring that their group health plans provide
EHB. Insurers may be required, however, to ensure that the group policies they sell to
employers in the small group market or through an insurance exchange provide EHB. Self-
insured, grandfathered and large-market insured group health plans are not required to
provide EHB at all.

NOTE: The significance of the term essential health benefits (as well as the confusingly
similar term “minimum essential coverage”) is discussed in Willis Human Capital Practice
Alert, July 2011, “Looking Ahead – Compliance After 2011.”




                                                               4                                 Willis North America • 05/12
Employers are responsible for ensuring that the group health plans they sponsor –
whether insured, self-insured, grandfathered or non-grandfathered – comply with the
health care reform law’s provisions regarding annual and lifetime dollar limits. (There
are several types of excepted benefits programs which need not comply, as explained in
Willis Human Capital Practice Alert, July 2011, “Looking Ahead – Compliance After
2011.”) The annual and lifetime dollar limits provisions apply only with respect to EHB
– they do not limit plans’ ability to impose dollar limits on non-EHB.

FAQS ADDRESS COMPLIANCE WITH LIFETIME AND ANNUAL LIMITS PROVISIONS
The provisions regarding lifetime and annual dollar limits on EHB are currently in
effect, but one of the open questions about them has been which of the benefits a plan
offers is non-EHB which may be subject to such limits. See Willis Human Capital
Practice Alert, July 2010, “Patient’s Bill of Rights Guidance Issued.” The enforcing
agencies have said that they will take into account good faith efforts to comply with a
reasonable interpretation of EHB until regulations defining the term are finalized. With
specifics on exactly which benefits are EHB lacking, however, most employers have
simply not applied lifetime or annual dollar limits to any benefits. Multi-state
employers were particularly disappointed when previous HHS releases indicated that
regulations will allow each state to define EHB for itself.

The new FAQs provide some details on the meaning of EHB for purposes of the annual
and lifetime dollar limits provisions, at least for group health plans that are self-insured,
grandfathered or provided through large-market insurance policies. Such plans may
choose any one definition of EHB that is authorized by HHS, and the enforcing agencies
will treat that as a permissible EHB definition for purposes of the lifetime and annual
limits provisions. It seems clear that, once the individual states’ definitions are in place,
an employer may choose any one of those definitions and amend its plan to impose
lifetime or annual dollar limits on benefits that are outside of that definition. It is
unclear exactly what plans may or must do between now and the time that states
finalize their EHB definitions.

The National Legal & Research Group will continue to monitor developments involving
this issue and provide information on them as needed.


MARYLAND ALLOWS SAME-SEX MARRIAGE
On March 1, 2012, the governor of Maryland, Martin O’Malley (D), signed the Civil
Marriage Protection Act (HB 438). This law will allow same-sex couples to marry
starting January 1, 2013. Opponents of the law have stated their intent to gather enough
signatures to put the law up to a voter referendum that would appear on the November
2012 ballot.

Maryland currently requires insurance carriers to offer domestic partner coverage if
requested by the policyholder. Insurers will now be required to provide coverage to
same-sex spouses whether the policyholder requests the coverage or not. Self-insured
plans that are governed by ERISA will not be affected by the state law. Regardless of
what Maryland law says, it will generally be trumped by federal law. Therefore, same-
sex spouses are typically treated as non-spouses for all federal laws – that includes
COBRA, federal tax, FMLA, etc. However, same-sex spouses will be eligible for those
benefits and rights conferred by Maryland law.




                          5                                       Willis North America • 05/12
Maryland joins Connecticut, Iowa, Massachusetts, New Hampshire, New York, Vermont, the state of
Washington (legislation legalizing same-sex marriage was signed on February 13, 2012 and is effective
June 7, 2012) and Washington D.C. in legalizing same-sex marriage. For a discussion on how same-sex
marriage affects employers and employer-sponsored benefits, please see Willis Human Capital
Practice HR Focus, August 2011, Issue 50, “New York Enacts Same-Sex Marriage Law.”


SAN FRANCISCO: HCSO ANNUAL REPORTING FORM
NOW AVAILABLE
San Francisco’s Health Care Security Ordinance (HCSO) requires that medium and large businesses
make certain minimum contributions toward their San Francisco employees’ health care. Under this
mandate, an employer may either contribute at least the minimum amount to a medical plan or other
health benefits or pay that amount into the publicly available program established by the HCSO. (See
Willis Human Capital Practice Alert, Issue 112, for additional details on the HCSO’s requirements.)
The HCSO requires covered employers to report on their health care expenditures by April 30 of each
year. A copy of the 2011 ARF is now available on the Office of Labor Standards Enforcement’s (OLSE)
website.

The ARF has been updated to reflect the HCSO amendments that were effective January 1, 2012. For
information about the amendments, please see Willis Human Capital Practice HR Focus, January
2012, Issue 55, “San Francisco Health Care Ordinance Amended.”


CHIP MODEL NOTICE REVISED
The Department of Labor’s (DOL) Employee Benefit Security Administration (EBSA) has released an
updated CHIP model notice. The revised notice can be found by clicking here. A printable version is
also available by clicking here. The DOL also makes the notice available in Spanish; click here.

Employers who had already fulfilled the CHIP notice requirement prior to the release of the new
notice are not affected by the revised notice (redistribution of the notice is not required). However,
employers who have not yet complied with the notice’s annual distribution requirement will want to
be sure they use the most recent notice.

BACKGROUND
An employer is required under the Children’s Health Insurance Program Reauthorization Act
(CHIPRA) to provide a CHIP notice if it maintains an insured or self-insured group health plan under
which it offers benefits in a state that provides a premium assistance subsidy under Medicaid or
CHIP. An employer must provide the CHIP notice to employees who reside in these states, regardless
of the employer’s location or principal place of business (or the location or principal place of business
of the group health plan, its administrator, its insurer or any other service provider affiliated with the
employer or the plan), and regardless of an employee’s enrollment status in the employer’s group
health plan.

Employers were required to provide an initial CHIP notice by the later of either (1) the first day of the
first plan year after February 4, 2010 or (2) May 1, 2010. Accordingly, for plan years that began
between February 4, 2010, and May 1, 2010, employers should have provided the CHIP notice by May
1, 2010. For plans with plan years that began after May 1, 2010, employers should have provided the
CHIP notice by the first day of the plan year (i.e., January 1, 2011, for calendar year plans). After
distributing the initial CHIP notice, employers must provide the notice annually.




                                                                 6                                  Willis North America • 05/12
SINCE YOU ASKED:
HSA CONTRIBUTION LIMITS:
ACCOUNT HOLDERS, SPOUSES AND
ADULT, NON-DEPENDENT CHILDREN
The National Legal & Research Group (NLRG) is frequently asked
about who may contribute to a Health Savings Account (HSA) and
who is eligible for tax-free reimbursements from an HSA. NLRG was
recently asked several questions in regard to an employee, age 59,
who elected to cover an adult child under an HSA-qualified high de-
ductible health plan (HDHP). She elected full family coverage, cov-
ering herself, her spouse, age 60, and the adult child. The spouse also
has an HSA-qualified HDHP through his employer and has also
elected full family coverage (covering himself, his spouse and the
adult child). The adult child does not qualify as a tax dependent
under Internal Revenue Code (IRC) §152 as a “qualifying relative”
but was added to the parents’ coverage following enactment of the
Patient Protection and Affordable Care Act of 2010 (PPACA). PPACA
requires employer-sponsored group health plans that provide cover-
age for employees’ children to make that coverage available until the
child reaches age 26.

NLRG received the following questions regarding this situation:

1. How much can the employee contribute to her HSA?
2. How much can the spouse contribute to his HSA?
3. What is the interaction, if any, between the employee’s and the
   spouse’s ability to contribute to their individual HSAs?
4. Can the adult child contribute to her own HSA, and, if so,
   how much?

BACKGROUND                                                                HSA CONTRIBUTIONS ANYONE, EVERYONE?
In order to make a tax-deductible contribution to an HSA, a person        HSAs are individual accounts, owned by
must be an “eligible individual.” A person is an eligible individual,     individuals. The HDHP, however, is an employer-
with respect to any month, if the person is:                              sponsored group health plan. While the employer
                                                                          sets the eligibility criteria for the HDHP, federal
    Covered by a plan that qualifies as a high deductible health plan     tax rules determine whether an individual with an
    (HDHP)                                                                HDHP can enroll in and contribute to an HSA.
    Not covered at the same time by any other plan which is not an        These rules also determine how much they can
    HDHP, but which covers the same benefits as the HDHP (other           contribute to the HSA.
    health plans include general purpose health Flexible Spending
    Accounts)                                                             The amount that the account holder or any other
    Not claimed as a dependent on another person's tax return (a          person (e.g., an employer) can contribute to the
    spouse is not considered to be a tax dependent under either IRC       account holder’s HSA depends on the category of
    §§151 or 152, even though a taxpayer may claim an exemption for       HDHP coverage the account holder has (i.e., self-
    the spouse)                                                           only or family), the account holder’s age, the date
    Not enrolled (not just eligible, but actually enrolled) in Medicare   the account holder becomes an eligible individual,
    Part A or B (eligible employees age 65 or over may contribute to      and the date the account holder ceases to be an
    an HSA, including the catch-up contribution, as long as they are      eligible individual. For 2012, if the account holder
    not enrolled in Medicare)



                                                              7                                     Willis North America • 05/12
has self-only HDHP coverage he can contribute up to $3,100, and if          Finally, to answer the last question on
the account holder has family HDHP coverage he can contribute up            whether the adult child can contribute to her
to $6,250. The HSA contribution limit for an HSA-eligible individual        HSA and how much, the maximum
who has family HDHP coverage is not affected merely because one or           contribution limit is determined for each
more of the other covered family members also has non-HDHP                  “eligible individual.” In the current situation,
coverage or HDHP coverage with a lower deductible.                          the adult, non-dependent child is not a
                                                                            dependent eligible to be claimed on the
If the account holder is an eligible individual who is age 55 or older at   parent’s tax return. In addition, she is also
the end of the account holder’s tax year (usually December 31), the         covered by a plan that qualifies as an HDHP
account holder’s contribution limit is increased by $1,000. For             (she is actually covered by two HDHPs).
example, if the account holder has self-only coverage, he can               Assuming she is not covered by a non-HDHP
contribute up to $4,100 (the contribution limit for self-only coverage      and she is not enrolled in Medicare, she will be
($3,100 for 2012) plus the additional contribution of $1,000).              an “eligible individual.” This means she would
                                                                            be eligible to establish her own HSA. Since
There are special contribution rules for married individuals. If            she has family HDHP coverage, she would be
either spouse has family HDHP coverage, both spouses are treated as         allowed to contribute up to the maximum
having only that family HDHP coverage. If each spouse has family            family contribution amount ($6,250 in 2012).
coverage under a separate plan, their combined contribution limit
for 2012 is $6,250. The contribution limit is split equally between         CONCLUSION
the spouses unless they agree on a different division. If both spouses       To summarize who can contribute what in the
are 55 or older, each spouse's contribution limit is increased by the       fact pattern provided above, the employee and
additional $1,000 catch-up contribution. If both spouses meet the           spouse could make a combined HSA
age requirement, their total HSA contributions cannot be more than          contribution of $6,250, split between their
$8,250 ($6,250 plus the additional $2,000 in catch-up                       HSAs however they see fit, plus they can each
contributions). Each spouse must make the additional catch-up               make an additional $1,000 catch-up
contribution to his or her own HSA (“joint” HSAs do not exist).             contribution, as they are both over age 55, to
                                                                            their respective HSAs (a grand total HSA
The maximum annual HSA contribution for the year is based upon              contribution between them of $8,250). The
the individual’s category of HDHP coverage (self-only or family) on         adult, non-dependent child could contribute
the first day of the last month of the account holder’s tax year             up to $6,250 to her own HSA.
(December 1 for most taxpayers). For example, if the account holder
had family HDHP coverage on the first day of December, his                   Taken as a group, the family is essentially able
contribution limit for 2012 is $6,250 (this is true even if the account     to contribute a combined $14,500 into HSAs
holder had single coverage earlier in the year). In other words, the        in 2012. And, if the parents had a second
account holder is treated as having the same HDHP coverage for the          adult, non-dependent child under the same
entire year as he had on the first day of that last month. This              HDHP, the total would be $20,750. The tax
maximum contribution level, however, is contingent on maintaining           code provides an incentive for adult, non-
HDHP coverage throughout a specified testing period. The testing             dependent children, to aggressively fund an
period begins with the last month of the account holder’s tax year          HSA (on a tax preferred basis) while covered
and ends on the last day of the 12th month following that month (a          under a parent’s employer-sponsored HDHP.
total of 13 months). For example, December 1, 2012 through
December 31, 2013 would be the testing period for contributions             For questions about whether an adult child
made in the 2012 tax year.                                                  who is not a tax dependent may have his
                                                                            medical expenses reimbursed through a
So, to answer questions 1, 2 and 3, each spouse, as they both meet the      parent’s HSA, please see Willis Human Capital
age requirement, can fund their own HSA with the $1,000 catch-up            Practice HR Focus, June 2011, Issue No. 48,
contribution and they can contribute an additional $6,250 – either          “Since You Asked: Who is Eligible for Tax-
put $3,125 in each HSA account or split any other way the spouses           Free HSA Reimbursements?”
agree upon (the spouses should discuss with their tax adviser the
issue of who should make what HSA contribution).




                                                            8                                      Willis North America • 05/12
WELLNESS
ASSESSING THE HEALTH OF YOUR POPULATION
Identifying risk factors in an employee population is the first step toward improving overall health and controlling
health care spending. Perhaps the most effective way for employers to do this is to offer questionnaires, commonly
referred to as a health assessment (HA) to their employees.

WHAT IS A HEALTH ASSESSMENT?
An HA is a questionnaire that gathers information from individuals in order to identify their risk factors for health
conditions and diseases. Typically HAs collect information on demographics, individual medical history, lifestyle
behaviors and biometric data such as blood pressure and cholesterol level. After completing an HA, participants are
provided with individualized feedback and information on any identified risk factors in order to improve health,
sustain health and/or prevent disease. According to the 16th Annual National Business Group on Health/Towers Watson
Survey Report, 79% of employers’ surveyed offer HAs.

WHY OFFER A HEALTH ASSESSMENT?
To:
      Provide behavioral motivators for your employees and their dependents
      Predict future health care trends
      Create targeted messaging for worksite wellness programming
      Provide employee health awareness and determine appropriate program intervention
      Improve health plan design and services through valuable feedback

Employers should examine their organizational culture and choose an administration format that will best meet the
needs of the majority of their employees. All assessments should be written at or below a sixth grade reading level.
Typically, an older workforce and retirees prefer a paper-based questionnaire. Most employers are offering an
electronic HA to their workforce, or transitioning from paper-based to electronic HAs. Reasons for the migration
include greater freedom over question customization, better integration with other program data and the opportunity
to provide instant feedback.

HEALTH ASSESSMENT COMPONENTS
These should be structured so that they:
   Provide a personalized follow-up report to employees
   Are electronically available
   Assess readiness to change
   Cover risk factors recommended by the United States Preventive Services Task Force
   Incorporates clinical values, such as blood pressure, cholesterol levels, body mass index and/or waist
   circumference
    Assess stress level
   Assess physical activity level

                                                         9                                      Willis North America • 05/12
Assess tobacco and drug use
    Assess absenteeism and/or presenteeism (ideally, both)
    Can, if the employer has a clinical staff onsite be integrated with
    clinical information gathered by onsite staff

WHAT ARE THE DIFFERENT METHODS OF FOLLOW-UP TO A HEALTH
ASSESSMENT?
Employees should always be granted the option of being contacted after
an assessment. Once a risk factor is identified and the employee has given
his or her consent to be contacted, a variety or a combination of different
follow-up methods can be used.

POPULAR FOLLOW-UP METHODS INCLUDE:
    Health coach contact; telephonic (recommended for first contact),
    electronic or in person
    Electronic personalized materials or links to resources
    24-hour nurse line
    Tear-off sheet to take to the employee’s physician
    Review with personal wellness coordinator
    Follow-up with occupational health nurses/health professionals at
    the work site
    Immediate one-on-one counseling by subject matter expert/health
    professional

Offering several options for employee follow-up allows the greatest
chance of achieving high satisfaction as well as removing potential
barriers to compliance. Reports indicate that when information and
resources are convenient for people to access they are more likely to use
them. Reports indicate that one-on-one counseling sessions achieve the
greatest employee satisfaction levels, and they are highly recommended
for initial contacts. Once the employee has been contacted, the contacting
party can ask how the employee prefers to be reached in the future.

Implementing a health assessment can be the first step in creating a
comprehensive wellness program in your organization. For additional
tools and resources, please contact your local Willis Associate.




            10                                     Willis North America • 05/12
WEBCASTS
SOLVING COMPLIANCE                                                    HEALTH REFORM:
PROBLEMS                                                              WHAT THE SUPREME
UNDER THE NEW FMLA                                                    COURT SAID; WHAT
REGULATIONS                                                           THE SUPREME COURT
TUESDAY, MAY 15, 2012
                                                                      WILL SAY.
2:00 PM EASTERN TIME                                                  TUESDAY, JUNE 19, 2012
Presented by:
                                                                      2:00 PM EASTERN TIME
KIMBERLY HARRELL, MS PHR, SR.
                                                                      Presented by:
HUMAN RESOURCES CONSULTANT,
                                                                      PRESENTED BY
HR PARTNER
                                                                      JACK TOWARNICKY, JD
                                                                      EMPLOYEE BENEFITS ATTORNEY,
The recently issued Family and Medical
                                                                      WILLIS NATIONAL LEGAL &
Leave Act (FMLA) regulations are requiring
                                                                      RESEARCH GROUP
employers to rethink their FMLA policies,
procedures and documentation.
                                                                      Recently the U.S. Supreme Court heard
                                                                      oral arguments about four specific issues
The new regulations also provide
                                                                      regarding the Patient Protection and
interpretations to major FMLA
                                                                      Affordable Care Act of 2010. The issues
developments, including GINA’s safe harbor
                                                                      were whether the legal challenge was
rules and the in loco parentis rule.
                                                                      timely, whether the individual mandate is
                                                                      constitutional, whether the individual
These new regulations have not lessened the
                                                                      mandate can be severed from the rest of
confusion for employers, especially in areas
                                                                      the law and whether expanded Medicaid
such as determining what is a qualifying
                                                                      coverage is an impermissible mandate on
serious health condition, complying with
                                                                      the states.
notification and certification requirements,
and providing intermittent leave.
                                                                      Join Willis’ National Legal Research
                                                                      Group for a Health Reform Update.
Please join us for an informational overview
                                                                      We will review the implications of the
of FMLA as it exists today, including recent
                                                                      Supreme Court decision as well as next
court cases interpreting FMLA, as well as an
                                                                      steps in terms of compliance for
updated look at what the future holds for
                                                                      employer-sponsored health plans.
FMLA legislation and strategic enforcement.

PARTICIPANT ACCESS                                                    If the decision is delayed, we will scope
                                                                      out the various permutations of these
Advance reservations are required to
                                                                      issues and how a favorable or unfavorable
participate. Click here to RSVP for
                                                                      ruling for each might impact employer-
this call.
                                                                      sponsored coverage. Immediately after
                 These programs have been approved for 1              the decision is announced, we will follow
                 (General) recertification credit hour toward PHR,
                 SPHR and GPHR recertification through the HR
                                                                      up with an Alert.
                 Certification Institute. For more information
                 about certification or recertification, please visit
                 the HR Certification Institute website at
                                                                      PARTICIPANT ACCESS
www.hrci.org. The use of this seal is not an endorsement by the HR    Advance reservations are required to
Certification Institute of the quality of the program. It means that   participate. Click here to RSVP for
this program has met the HR Certification Institute’s criteria to be
pre-approved for recertification credit.                               this call.

                                          11                                           Willis North America • 05/12
KEY CONTACTS
U.S. HUMAN CAPITAL PRACTICE OFFICE LOCATIONS


NEW ENGLAND            Wilmington, DE          Jacksonville, FL
                       302 397 0171            904 355 4600
Auburn, ME
207 783 2211           ATLANTIC                Marietta, GA
                                               770 425 6700
Bangor, ME             Baltimore, MD
207 942 4671           410 584 7528            Miami, FL
                                               305 421 6208
Boston, MA             Bethesda, MD
617 437 6900           301 581 4261            Mobile, AL
                                               251 544 0212
Burlington, VT         Knoxville, TN
802 264 9536           865 588 8101            Orlando, FL
                                               407 562 2493
Hartford, CT           Memphis, TN
860 756 7365           901 248 3103            Raleigh, NC
                                               704 344 4856
Manchester, NH         Nashville, TN
603 627 9583           615 872 3716            Savannah, GA
                                               912 239 9047
Portland, ME           Norfolk, VA
207 553 2131           757 628 2303            Tallahassee, FL
                                               850 385 3636
Shelton, CT            Reston, VA
203 924 2994           703 435 7078            Tampa, FL
                                               813 490 6808
NORTHEAST              Richmond, VA            813 289 7996
                       804 527 2343
Buffalo, NY                                    Vero Beach, FL
716 856 1100           Rockville, MD           772 469 2842
                       301 692 3025
Cranford, NJ                                   MIDWEST
908 931 3005           SOUTHEAST
                                               Appleton, WI
Florham Park, NJ       Atlanta, GA             800 236 3311
973 410 4622           404 224 5000
                                               Chicago, IL
Morristown, NJ         Birmingham, AL          312 288 7700
973 829 6374           205 871 3300            312 348 7700
973 829 6465
                       Charlotte, NC           Cleveland, OH
New York, NY           704 344 4856            216 861 9100
212 915 8802
                       Gainesville, FL         Columbus, OH
Norwalk, CT            352 378 2511            614 326 4722
203 523 0501
                       Greenville, SC          Detroit, MI
Radnor, PA             704 344 4856            248 539 6600
610 254 7289




                                      12                      Willis North America • 05/12
Grand Rapids, MI    San Antonio, TX
616 957 2020        210 979 7470

Milwaukee, WI       Wichita, KS
414 203 5248        316 263 3211
414 259 8837
                    WESTERN
Minneapolis, MN
763 302 7131        Fresno, CA
763 302 7209        559 256 6212

Moline, IL          Irvine, CA
309 764 9666        949 885 1200

Pittsburgh, PA      Las Vegas, NV
412 645 8506        602 787 6235
                    602 787 6078
Schaumburg, IL
847 517 3469        Los Angeles, CA
                    213 607 6300
SOUTH CENTRAL
                    Novato, CA
Amarillo, TX        415 493 5210
806 376 4761
                    Phoenix, AZ
Austin, TX          602 787 6235
512 651 1660        602 787 6078

Dallas, TX          Portland, OR
972 715 2194        503 274 6224
972 715 6272
                    Rancho/Irvine, CA
Denver, CO          562 435 2259
303 765 1564
303 773 1373        San Diego, CA
                    858 678 2000
Houston, TX         858 678 2132
713 625 1017
713 625 1082        San Francisco, CA
                    415 291 1567
McAllen, TX
956 682 9423        San Jose, CA
                    408 436 7000
Mills, WY
307 266 6568        Seattle, WA
                    800 456 1415
New Orleans, LA
504 581 6151
                    The information contained in this publication is
                    not intended to represent legal or tax advice and
Oklahoma City, OK   has been prepared solely for educational
405 232 0651        purposes. You may wish to consult your attorney
                    or tax adviser regarding issues raised in this
Overland Park, KS   publication.
913 339 0800




                                         13                             Willis North America • 05/12

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HR Metrics Tell Your Organization's Strategic Story

  • 1. HUMAN CAPITAL PRACTICE HRFocus May 2012 — Issue 59 www.willis.com HR CORNER 10 TIPS TO AVOID A DOL WAGE & HOUR INVESTIGATION Knock, knock … Surprise! Believe it or not, the federal Department of Labor (DOL) does not require an investigator to previously announce the scheduling of a wage & hour investigation. The investigator has sufficient latitude to initiate unannounced wage & hour investigations, in many cases, in order to directly observe normal business operations and quickly develop factual information. The following are some strategies to prevent this knock from sounding at your company’s front door! AVOID UNFAIR COMPENSATION PRACTICES Make sure employees are compensated in a consistent manner. If an employer’s pay practices are consistent, complaints are less likely to arise, and the employer will be in a better situation if DOL does TABLE OF CONTENTS launch a wage & hour investigation. HR CORNER UNDERSTAND THE REGULATIONS 10 Tips To Avoid A DOL Wage It is important that employers take the time and make a concerted & Hour Investigation 1 effort to understand and familiarize themselves with the Fair Labor HR Metrics: 10 Ways To Assess Standards Act (FLSA). It is the law, and if employers fail to follow the Strategic Business Context Of law they may face litigation or a DOL audit. Your Organization 2 LEGAL & COMPLIANCE TRAINING Train managers so they are fluent in the language of the FLSA. ERRP Funds Exhausted 3 FAQS On How HHS Will Define ANALYZE STATE VERSUS FEDERAL LAW Essential Health Benefits 4 Determine whether the state’s wage & hour laws conflict with federal Maryland Allows Same-Sex Marriage 5 law, then follow the law that is most beneficial to the employee. San Francisco: HCSO Annual Reporting Form Now Available 6 PAY PAST OVERTIME DUE CHIP Model Notice Revised 6 If it is determined that an employee is wrongly classified as exempt, the employer should determine how many overtime hours the SINCE YOU ASKED employee has worked in the past 2 years, then pay the employee the HSA Contribution Limits: overtime due. The employer should also have the employee sign a Account Holders, Spouses And Adult, release to free the employer from further liability. Paying past Non-Dependent Children 7 overtime due to employees now will be far less expensive than paying WELLNESS them in a DOL settlement. Assessing The Health Of Your Population 9 FOLLOW CHILD LABOR LAWS WEBCASTS 11 Employers must determine a minor’s age and set his or her job duties and work schedules accordingly and carefully. Also, employers must CONTACTS 12
  • 2. file the minor employee’s age certificate, keeping it for as long as the minor is employed. HR METRICS: 10 WAYS TO ASSESS STRATEGIC PAY YOUR INTERNS, UNLESS THEY MEET A STRICT TEST Internships in the for-profit, private sector will most often BUSINESS CONTEXT OF be viewed as employment by the DOL, unless a strict test is met. Interns who qualify as employees rather than trainees YOUR ORGANIZATION typically must be paid at least the minimum wage and HR metrics are the key for HR professionals to be overtime compensation for hours worked over 40 in a active participants in a business’ strategic decisions. workweek. HR metrics provide the means for HR professionals to communicate with management. However, RESPOND TO INTERNAL COMPLAINTS EXPEDITIOUSLY typically, busy HR leaders can spend only 10 percent of If an employee files a wage & hour complaint internally, the their time at the strategic level, and only 2 in 10 have a employer should take it seriously. Since many process in place for measuring the business investigations are prompted by an employee’s complaint, performance of employees. These numbers indicate employers might be able to prevent an investigation by that success is not being measured as well as it should addressing an employee’s initial internal complaint. be, which can ultimately keep HR from being the key contributor to organizational success that it could be. SEEK COMPLIANCE ASSISTANCE FROM DOL In a BLR webinar titled “HR Metrics: How to Measure Various compliance tools and information are available on and Communicate Your Strategic Value in Bottom- DOL's website. Line Terms,” Ronald Adler and Jennifer Burdick outlined how the use of HR metrics allows HR CONDUCT A SELF-AUDIT professionals to tell their story effectively. Employers can hire attorneys to audit their companies—or they can do it themselves before DOL initiates an HR METRICS: TELLING YOUR STORY investigation. Conducting a self-audit helps ensure HR Metrics are about telling a story about your compliance with federal and state laws. As part of an audit, organization. Like other stories, your story: employers should: Must have context Review job descriptions to determine whether they are Should consider historical information (lagging still accurate, reflect the jobs being performed, and indicators) reflect the skills necessary to perform the job. Should report current information (coincident Review employees’ actual job duties to ensure that they indicators) still fall within the administrative, executive, Should indicate possible future events (leading professional, computer, or outside sales exemptions. indicators and predictive analytics) Make sure overtime for nonexempt employees has Should consider its audience (there is a growing been properly calculated list of internal and external stakeholders and users Make sure the required posters have been hung in the of HR metrics) appropriate places in the workplace. Should engage the audience and motivate action DOL investigators look for complete, accurate, and What stories do your metrics tell about your unambiguous pay records for every employee for each pay organization’s human capital and HR management? period from the past 3 years. As a result, it is imperative Are your executives listening? that employers strive to keep accurate, well-organized wage & hour records that can be produced quickly. If violations are found, the employer may owe back pay, face penalties, and be advised by DOL to make changes in employment practices in order to avoid future violations. This article provided by BLR. 2 Willis North America • 05/12
  • 3. HR METRICS: STRATEGIC BUSINESS CONTEXT The starting point in developing the right metrics to effectively tell your story is to fully understand the strategic business context you’re working in. Here are 10 areas to assess in order to understand the strategic business context of your organization: How does your organization produce revenue? How does human resources add value to your organization? Are HR activities and employment practices aligned with your organization’s strategic and business goals and objectives? How do human resources impact these objectives? What are your organization’s key business measurements and metrics currently? How does your organization measure success? What’s on your organization’s scorecard? Adler noted that this is a starting point for your whole discussion. How do human resources impact your organization’s key business measurements and metrics? What are your organization’s business imperatives, i.e., what distinguishes your organization in the marketplace? How do HR activities and employment practices impact these imperatives? What are your organization’s risks and opportunities? How do HR activities and employment practices impact these risks? What decisions do you want to influence? Can you connect the dots between the metric and decision making? What happens if your organization misses the target? By understanding these 10 areas, you can begin to best understand what HR metrics will be most useful to develop and which will best tell your story to the organization’s leaders. This article provided by BLR. LEGAL & COMPLIANCE ERRP FUNDS EXHAUSTED On February 17, 2012, the Early Retiree Reinsurance Program (ERRP) announced that requests for reimbursement had exceeded the $5 billion funding allocated to the program. Reimbursement requests which exceed the program's $5 billion will now be held in the order of receipt, pending the availability of funds. Plan sponsors with reimbursement requests on hold can expect to receive an email notifying them that their reimbursement requests have been placed on hold pending the availability of funds. Plan sponsors who have received such an email can call the ERRP Contact Center to obtain updated information on the position of the reimbursement request in the list of held reimbursement requests. The Centers for Medicare & Medicaid Services (CMS) has indicated it will continue to pay reimbursement requests in the order received until available funds are exhausted. If there are not sufficient funds to pay in its entirety the first reimbursement request that causes the initial exhaustion of the funds available for payment, CMS will partially honor that reimbursement request, and will pay the balance of that reimbursement request if additional funds become available through overpayment recoupment efforts. In the event that funds become available as a result of overpayment collections, CMS will pay subsequent reimbursement requests in the order of receipt until funds are once again exhausted. Related to ongoing ERRP requirements, CMS has announced its expectation that plan sponsors will use ERRP reimbursement funds they have received, or will receive, as soon as possible, but in no case later than December 31, 2014. Plan sponsors can view the Common Question on this topic, 800-13, which is posted in the "Use of Reimbursement" section of the Common Questions on www.errp.gov. 3 Willis North America • 05/12
  • 4. BACKGROUND The ERRP was established by the health care reform law with appropriated funding of $5 billion. It became effective June 1, 2010. The program provides reimbursement to plan sponsors of participating employment-based plans for a portion of the cost of health benefits for early retirees and their spouses, surviving spouses and dependents. In order to obtain reimbursement under the ERRP, plan sponsors had to first submit a completed application to the Department of Health and Human Services (HHS) and be accepted into the program. HHS began accepting ERRP applications on June 29, 2010 but stopped accepting them in May 2011. The program was slated to end no later than January 1, 2014, but HHS had the authority to stop taking ERRP applications based on the availability of funding. Once a plan sponsor’s ERRP application was accepted, the plan sponsor could submit documentation of actual costs for early retiree health care benefits and receive reimbursement from the ERRP. Claim reimbursements began in October 2010. In December 2011, ERRP announced that reimbursements would be unavailable for claims incurred after December 31, 2011. For more information on the ERRP, see Willis Human Capital Practice Alert, Vol. 3, No. 7, “It’s a Start: Guidance on the Early Retiree Reinsurance Program.” FAQS ON HOW HHS WILL DEFINE ESSENTIAL HEALTH BENEFITS The Department of Health and Human Services (HHS) has added a set of FAQs to its previous releases on the approach it intends to follow in defining “essential health benefits” (EHB). NOTE: The health care reform law directs the relevant agencies to define EHB so that a plan providing EHB will be similar in scope to typical employer-provided health benefits and will include coverage in 10 broad categories of health care. HHS has indicated that it intends to issue regulations under which each state chooses a benchmark plan from among several options and then determines what must be added so that the resulting plan provides coverage of all 10 categories of health care that the statute specifies for EHB. This means that there will be multiple state-specific definitions of EHB, rather than a single definition. The new FAQs primarily provide details on how HHS will work with states to define EHB. They also include, however, information on how an employer would use the EHB definition in complying with the lifetime and annual dollar limits provisions of the health care reform law. WHY THE EHB DEFINITION MATTERS TO EMPLOYERS SPONSORING HEALTH PLANS Employers generally are not responsible for ensuring that their group health plans provide EHB. Insurers may be required, however, to ensure that the group policies they sell to employers in the small group market or through an insurance exchange provide EHB. Self- insured, grandfathered and large-market insured group health plans are not required to provide EHB at all. NOTE: The significance of the term essential health benefits (as well as the confusingly similar term “minimum essential coverage”) is discussed in Willis Human Capital Practice Alert, July 2011, “Looking Ahead – Compliance After 2011.” 4 Willis North America • 05/12
  • 5. Employers are responsible for ensuring that the group health plans they sponsor – whether insured, self-insured, grandfathered or non-grandfathered – comply with the health care reform law’s provisions regarding annual and lifetime dollar limits. (There are several types of excepted benefits programs which need not comply, as explained in Willis Human Capital Practice Alert, July 2011, “Looking Ahead – Compliance After 2011.”) The annual and lifetime dollar limits provisions apply only with respect to EHB – they do not limit plans’ ability to impose dollar limits on non-EHB. FAQS ADDRESS COMPLIANCE WITH LIFETIME AND ANNUAL LIMITS PROVISIONS The provisions regarding lifetime and annual dollar limits on EHB are currently in effect, but one of the open questions about them has been which of the benefits a plan offers is non-EHB which may be subject to such limits. See Willis Human Capital Practice Alert, July 2010, “Patient’s Bill of Rights Guidance Issued.” The enforcing agencies have said that they will take into account good faith efforts to comply with a reasonable interpretation of EHB until regulations defining the term are finalized. With specifics on exactly which benefits are EHB lacking, however, most employers have simply not applied lifetime or annual dollar limits to any benefits. Multi-state employers were particularly disappointed when previous HHS releases indicated that regulations will allow each state to define EHB for itself. The new FAQs provide some details on the meaning of EHB for purposes of the annual and lifetime dollar limits provisions, at least for group health plans that are self-insured, grandfathered or provided through large-market insurance policies. Such plans may choose any one definition of EHB that is authorized by HHS, and the enforcing agencies will treat that as a permissible EHB definition for purposes of the lifetime and annual limits provisions. It seems clear that, once the individual states’ definitions are in place, an employer may choose any one of those definitions and amend its plan to impose lifetime or annual dollar limits on benefits that are outside of that definition. It is unclear exactly what plans may or must do between now and the time that states finalize their EHB definitions. The National Legal & Research Group will continue to monitor developments involving this issue and provide information on them as needed. MARYLAND ALLOWS SAME-SEX MARRIAGE On March 1, 2012, the governor of Maryland, Martin O’Malley (D), signed the Civil Marriage Protection Act (HB 438). This law will allow same-sex couples to marry starting January 1, 2013. Opponents of the law have stated their intent to gather enough signatures to put the law up to a voter referendum that would appear on the November 2012 ballot. Maryland currently requires insurance carriers to offer domestic partner coverage if requested by the policyholder. Insurers will now be required to provide coverage to same-sex spouses whether the policyholder requests the coverage or not. Self-insured plans that are governed by ERISA will not be affected by the state law. Regardless of what Maryland law says, it will generally be trumped by federal law. Therefore, same- sex spouses are typically treated as non-spouses for all federal laws – that includes COBRA, federal tax, FMLA, etc. However, same-sex spouses will be eligible for those benefits and rights conferred by Maryland law. 5 Willis North America • 05/12
  • 6. Maryland joins Connecticut, Iowa, Massachusetts, New Hampshire, New York, Vermont, the state of Washington (legislation legalizing same-sex marriage was signed on February 13, 2012 and is effective June 7, 2012) and Washington D.C. in legalizing same-sex marriage. For a discussion on how same-sex marriage affects employers and employer-sponsored benefits, please see Willis Human Capital Practice HR Focus, August 2011, Issue 50, “New York Enacts Same-Sex Marriage Law.” SAN FRANCISCO: HCSO ANNUAL REPORTING FORM NOW AVAILABLE San Francisco’s Health Care Security Ordinance (HCSO) requires that medium and large businesses make certain minimum contributions toward their San Francisco employees’ health care. Under this mandate, an employer may either contribute at least the minimum amount to a medical plan or other health benefits or pay that amount into the publicly available program established by the HCSO. (See Willis Human Capital Practice Alert, Issue 112, for additional details on the HCSO’s requirements.) The HCSO requires covered employers to report on their health care expenditures by April 30 of each year. A copy of the 2011 ARF is now available on the Office of Labor Standards Enforcement’s (OLSE) website. The ARF has been updated to reflect the HCSO amendments that were effective January 1, 2012. For information about the amendments, please see Willis Human Capital Practice HR Focus, January 2012, Issue 55, “San Francisco Health Care Ordinance Amended.” CHIP MODEL NOTICE REVISED The Department of Labor’s (DOL) Employee Benefit Security Administration (EBSA) has released an updated CHIP model notice. The revised notice can be found by clicking here. A printable version is also available by clicking here. The DOL also makes the notice available in Spanish; click here. Employers who had already fulfilled the CHIP notice requirement prior to the release of the new notice are not affected by the revised notice (redistribution of the notice is not required). However, employers who have not yet complied with the notice’s annual distribution requirement will want to be sure they use the most recent notice. BACKGROUND An employer is required under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) to provide a CHIP notice if it maintains an insured or self-insured group health plan under which it offers benefits in a state that provides a premium assistance subsidy under Medicaid or CHIP. An employer must provide the CHIP notice to employees who reside in these states, regardless of the employer’s location or principal place of business (or the location or principal place of business of the group health plan, its administrator, its insurer or any other service provider affiliated with the employer or the plan), and regardless of an employee’s enrollment status in the employer’s group health plan. Employers were required to provide an initial CHIP notice by the later of either (1) the first day of the first plan year after February 4, 2010 or (2) May 1, 2010. Accordingly, for plan years that began between February 4, 2010, and May 1, 2010, employers should have provided the CHIP notice by May 1, 2010. For plans with plan years that began after May 1, 2010, employers should have provided the CHIP notice by the first day of the plan year (i.e., January 1, 2011, for calendar year plans). After distributing the initial CHIP notice, employers must provide the notice annually. 6 Willis North America • 05/12
  • 7. SINCE YOU ASKED: HSA CONTRIBUTION LIMITS: ACCOUNT HOLDERS, SPOUSES AND ADULT, NON-DEPENDENT CHILDREN The National Legal & Research Group (NLRG) is frequently asked about who may contribute to a Health Savings Account (HSA) and who is eligible for tax-free reimbursements from an HSA. NLRG was recently asked several questions in regard to an employee, age 59, who elected to cover an adult child under an HSA-qualified high de- ductible health plan (HDHP). She elected full family coverage, cov- ering herself, her spouse, age 60, and the adult child. The spouse also has an HSA-qualified HDHP through his employer and has also elected full family coverage (covering himself, his spouse and the adult child). The adult child does not qualify as a tax dependent under Internal Revenue Code (IRC) §152 as a “qualifying relative” but was added to the parents’ coverage following enactment of the Patient Protection and Affordable Care Act of 2010 (PPACA). PPACA requires employer-sponsored group health plans that provide cover- age for employees’ children to make that coverage available until the child reaches age 26. NLRG received the following questions regarding this situation: 1. How much can the employee contribute to her HSA? 2. How much can the spouse contribute to his HSA? 3. What is the interaction, if any, between the employee’s and the spouse’s ability to contribute to their individual HSAs? 4. Can the adult child contribute to her own HSA, and, if so, how much? BACKGROUND HSA CONTRIBUTIONS ANYONE, EVERYONE? In order to make a tax-deductible contribution to an HSA, a person HSAs are individual accounts, owned by must be an “eligible individual.” A person is an eligible individual, individuals. The HDHP, however, is an employer- with respect to any month, if the person is: sponsored group health plan. While the employer sets the eligibility criteria for the HDHP, federal Covered by a plan that qualifies as a high deductible health plan tax rules determine whether an individual with an (HDHP) HDHP can enroll in and contribute to an HSA. Not covered at the same time by any other plan which is not an These rules also determine how much they can HDHP, but which covers the same benefits as the HDHP (other contribute to the HSA. health plans include general purpose health Flexible Spending Accounts) The amount that the account holder or any other Not claimed as a dependent on another person's tax return (a person (e.g., an employer) can contribute to the spouse is not considered to be a tax dependent under either IRC account holder’s HSA depends on the category of §§151 or 152, even though a taxpayer may claim an exemption for HDHP coverage the account holder has (i.e., self- the spouse) only or family), the account holder’s age, the date Not enrolled (not just eligible, but actually enrolled) in Medicare the account holder becomes an eligible individual, Part A or B (eligible employees age 65 or over may contribute to and the date the account holder ceases to be an an HSA, including the catch-up contribution, as long as they are eligible individual. For 2012, if the account holder not enrolled in Medicare) 7 Willis North America • 05/12
  • 8. has self-only HDHP coverage he can contribute up to $3,100, and if Finally, to answer the last question on the account holder has family HDHP coverage he can contribute up whether the adult child can contribute to her to $6,250. The HSA contribution limit for an HSA-eligible individual HSA and how much, the maximum who has family HDHP coverage is not affected merely because one or contribution limit is determined for each more of the other covered family members also has non-HDHP “eligible individual.” In the current situation, coverage or HDHP coverage with a lower deductible. the adult, non-dependent child is not a dependent eligible to be claimed on the If the account holder is an eligible individual who is age 55 or older at parent’s tax return. In addition, she is also the end of the account holder’s tax year (usually December 31), the covered by a plan that qualifies as an HDHP account holder’s contribution limit is increased by $1,000. For (she is actually covered by two HDHPs). example, if the account holder has self-only coverage, he can Assuming she is not covered by a non-HDHP contribute up to $4,100 (the contribution limit for self-only coverage and she is not enrolled in Medicare, she will be ($3,100 for 2012) plus the additional contribution of $1,000). an “eligible individual.” This means she would be eligible to establish her own HSA. Since There are special contribution rules for married individuals. If she has family HDHP coverage, she would be either spouse has family HDHP coverage, both spouses are treated as allowed to contribute up to the maximum having only that family HDHP coverage. If each spouse has family family contribution amount ($6,250 in 2012). coverage under a separate plan, their combined contribution limit for 2012 is $6,250. The contribution limit is split equally between CONCLUSION the spouses unless they agree on a different division. If both spouses To summarize who can contribute what in the are 55 or older, each spouse's contribution limit is increased by the fact pattern provided above, the employee and additional $1,000 catch-up contribution. If both spouses meet the spouse could make a combined HSA age requirement, their total HSA contributions cannot be more than contribution of $6,250, split between their $8,250 ($6,250 plus the additional $2,000 in catch-up HSAs however they see fit, plus they can each contributions). Each spouse must make the additional catch-up make an additional $1,000 catch-up contribution to his or her own HSA (“joint” HSAs do not exist). contribution, as they are both over age 55, to their respective HSAs (a grand total HSA The maximum annual HSA contribution for the year is based upon contribution between them of $8,250). The the individual’s category of HDHP coverage (self-only or family) on adult, non-dependent child could contribute the first day of the last month of the account holder’s tax year up to $6,250 to her own HSA. (December 1 for most taxpayers). For example, if the account holder had family HDHP coverage on the first day of December, his Taken as a group, the family is essentially able contribution limit for 2012 is $6,250 (this is true even if the account to contribute a combined $14,500 into HSAs holder had single coverage earlier in the year). In other words, the in 2012. And, if the parents had a second account holder is treated as having the same HDHP coverage for the adult, non-dependent child under the same entire year as he had on the first day of that last month. This HDHP, the total would be $20,750. The tax maximum contribution level, however, is contingent on maintaining code provides an incentive for adult, non- HDHP coverage throughout a specified testing period. The testing dependent children, to aggressively fund an period begins with the last month of the account holder’s tax year HSA (on a tax preferred basis) while covered and ends on the last day of the 12th month following that month (a under a parent’s employer-sponsored HDHP. total of 13 months). For example, December 1, 2012 through December 31, 2013 would be the testing period for contributions For questions about whether an adult child made in the 2012 tax year. who is not a tax dependent may have his medical expenses reimbursed through a So, to answer questions 1, 2 and 3, each spouse, as they both meet the parent’s HSA, please see Willis Human Capital age requirement, can fund their own HSA with the $1,000 catch-up Practice HR Focus, June 2011, Issue No. 48, contribution and they can contribute an additional $6,250 – either “Since You Asked: Who is Eligible for Tax- put $3,125 in each HSA account or split any other way the spouses Free HSA Reimbursements?” agree upon (the spouses should discuss with their tax adviser the issue of who should make what HSA contribution). 8 Willis North America • 05/12
  • 9. WELLNESS ASSESSING THE HEALTH OF YOUR POPULATION Identifying risk factors in an employee population is the first step toward improving overall health and controlling health care spending. Perhaps the most effective way for employers to do this is to offer questionnaires, commonly referred to as a health assessment (HA) to their employees. WHAT IS A HEALTH ASSESSMENT? An HA is a questionnaire that gathers information from individuals in order to identify their risk factors for health conditions and diseases. Typically HAs collect information on demographics, individual medical history, lifestyle behaviors and biometric data such as blood pressure and cholesterol level. After completing an HA, participants are provided with individualized feedback and information on any identified risk factors in order to improve health, sustain health and/or prevent disease. According to the 16th Annual National Business Group on Health/Towers Watson Survey Report, 79% of employers’ surveyed offer HAs. WHY OFFER A HEALTH ASSESSMENT? To: Provide behavioral motivators for your employees and their dependents Predict future health care trends Create targeted messaging for worksite wellness programming Provide employee health awareness and determine appropriate program intervention Improve health plan design and services through valuable feedback Employers should examine their organizational culture and choose an administration format that will best meet the needs of the majority of their employees. All assessments should be written at or below a sixth grade reading level. Typically, an older workforce and retirees prefer a paper-based questionnaire. Most employers are offering an electronic HA to their workforce, or transitioning from paper-based to electronic HAs. Reasons for the migration include greater freedom over question customization, better integration with other program data and the opportunity to provide instant feedback. HEALTH ASSESSMENT COMPONENTS These should be structured so that they: Provide a personalized follow-up report to employees Are electronically available Assess readiness to change Cover risk factors recommended by the United States Preventive Services Task Force Incorporates clinical values, such as blood pressure, cholesterol levels, body mass index and/or waist circumference Assess stress level Assess physical activity level 9 Willis North America • 05/12
  • 10. Assess tobacco and drug use Assess absenteeism and/or presenteeism (ideally, both) Can, if the employer has a clinical staff onsite be integrated with clinical information gathered by onsite staff WHAT ARE THE DIFFERENT METHODS OF FOLLOW-UP TO A HEALTH ASSESSMENT? Employees should always be granted the option of being contacted after an assessment. Once a risk factor is identified and the employee has given his or her consent to be contacted, a variety or a combination of different follow-up methods can be used. POPULAR FOLLOW-UP METHODS INCLUDE: Health coach contact; telephonic (recommended for first contact), electronic or in person Electronic personalized materials or links to resources 24-hour nurse line Tear-off sheet to take to the employee’s physician Review with personal wellness coordinator Follow-up with occupational health nurses/health professionals at the work site Immediate one-on-one counseling by subject matter expert/health professional Offering several options for employee follow-up allows the greatest chance of achieving high satisfaction as well as removing potential barriers to compliance. Reports indicate that when information and resources are convenient for people to access they are more likely to use them. Reports indicate that one-on-one counseling sessions achieve the greatest employee satisfaction levels, and they are highly recommended for initial contacts. Once the employee has been contacted, the contacting party can ask how the employee prefers to be reached in the future. Implementing a health assessment can be the first step in creating a comprehensive wellness program in your organization. For additional tools and resources, please contact your local Willis Associate. 10 Willis North America • 05/12
  • 11. WEBCASTS SOLVING COMPLIANCE HEALTH REFORM: PROBLEMS WHAT THE SUPREME UNDER THE NEW FMLA COURT SAID; WHAT REGULATIONS THE SUPREME COURT TUESDAY, MAY 15, 2012 WILL SAY. 2:00 PM EASTERN TIME TUESDAY, JUNE 19, 2012 Presented by: 2:00 PM EASTERN TIME KIMBERLY HARRELL, MS PHR, SR. Presented by: HUMAN RESOURCES CONSULTANT, PRESENTED BY HR PARTNER JACK TOWARNICKY, JD EMPLOYEE BENEFITS ATTORNEY, The recently issued Family and Medical WILLIS NATIONAL LEGAL & Leave Act (FMLA) regulations are requiring RESEARCH GROUP employers to rethink their FMLA policies, procedures and documentation. Recently the U.S. Supreme Court heard oral arguments about four specific issues The new regulations also provide regarding the Patient Protection and interpretations to major FMLA Affordable Care Act of 2010. The issues developments, including GINA’s safe harbor were whether the legal challenge was rules and the in loco parentis rule. timely, whether the individual mandate is constitutional, whether the individual These new regulations have not lessened the mandate can be severed from the rest of confusion for employers, especially in areas the law and whether expanded Medicaid such as determining what is a qualifying coverage is an impermissible mandate on serious health condition, complying with the states. notification and certification requirements, and providing intermittent leave. Join Willis’ National Legal Research Group for a Health Reform Update. Please join us for an informational overview We will review the implications of the of FMLA as it exists today, including recent Supreme Court decision as well as next court cases interpreting FMLA, as well as an steps in terms of compliance for updated look at what the future holds for employer-sponsored health plans. FMLA legislation and strategic enforcement. PARTICIPANT ACCESS If the decision is delayed, we will scope out the various permutations of these Advance reservations are required to issues and how a favorable or unfavorable participate. Click here to RSVP for ruling for each might impact employer- this call. sponsored coverage. Immediately after These programs have been approved for 1 the decision is announced, we will follow (General) recertification credit hour toward PHR, SPHR and GPHR recertification through the HR up with an Alert. Certification Institute. For more information about certification or recertification, please visit the HR Certification Institute website at PARTICIPANT ACCESS www.hrci.org. The use of this seal is not an endorsement by the HR Advance reservations are required to Certification Institute of the quality of the program. It means that participate. Click here to RSVP for this program has met the HR Certification Institute’s criteria to be pre-approved for recertification credit. this call. 11 Willis North America • 05/12
  • 12. KEY CONTACTS U.S. HUMAN CAPITAL PRACTICE OFFICE LOCATIONS NEW ENGLAND Wilmington, DE Jacksonville, FL 302 397 0171 904 355 4600 Auburn, ME 207 783 2211 ATLANTIC Marietta, GA 770 425 6700 Bangor, ME Baltimore, MD 207 942 4671 410 584 7528 Miami, FL 305 421 6208 Boston, MA Bethesda, MD 617 437 6900 301 581 4261 Mobile, AL 251 544 0212 Burlington, VT Knoxville, TN 802 264 9536 865 588 8101 Orlando, FL 407 562 2493 Hartford, CT Memphis, TN 860 756 7365 901 248 3103 Raleigh, NC 704 344 4856 Manchester, NH Nashville, TN 603 627 9583 615 872 3716 Savannah, GA 912 239 9047 Portland, ME Norfolk, VA 207 553 2131 757 628 2303 Tallahassee, FL 850 385 3636 Shelton, CT Reston, VA 203 924 2994 703 435 7078 Tampa, FL 813 490 6808 NORTHEAST Richmond, VA 813 289 7996 804 527 2343 Buffalo, NY Vero Beach, FL 716 856 1100 Rockville, MD 772 469 2842 301 692 3025 Cranford, NJ MIDWEST 908 931 3005 SOUTHEAST Appleton, WI Florham Park, NJ Atlanta, GA 800 236 3311 973 410 4622 404 224 5000 Chicago, IL Morristown, NJ Birmingham, AL 312 288 7700 973 829 6374 205 871 3300 312 348 7700 973 829 6465 Charlotte, NC Cleveland, OH New York, NY 704 344 4856 216 861 9100 212 915 8802 Gainesville, FL Columbus, OH Norwalk, CT 352 378 2511 614 326 4722 203 523 0501 Greenville, SC Detroit, MI Radnor, PA 704 344 4856 248 539 6600 610 254 7289 12 Willis North America • 05/12
  • 13. Grand Rapids, MI San Antonio, TX 616 957 2020 210 979 7470 Milwaukee, WI Wichita, KS 414 203 5248 316 263 3211 414 259 8837 WESTERN Minneapolis, MN 763 302 7131 Fresno, CA 763 302 7209 559 256 6212 Moline, IL Irvine, CA 309 764 9666 949 885 1200 Pittsburgh, PA Las Vegas, NV 412 645 8506 602 787 6235 602 787 6078 Schaumburg, IL 847 517 3469 Los Angeles, CA 213 607 6300 SOUTH CENTRAL Novato, CA Amarillo, TX 415 493 5210 806 376 4761 Phoenix, AZ Austin, TX 602 787 6235 512 651 1660 602 787 6078 Dallas, TX Portland, OR 972 715 2194 503 274 6224 972 715 6272 Rancho/Irvine, CA Denver, CO 562 435 2259 303 765 1564 303 773 1373 San Diego, CA 858 678 2000 Houston, TX 858 678 2132 713 625 1017 713 625 1082 San Francisco, CA 415 291 1567 McAllen, TX 956 682 9423 San Jose, CA 408 436 7000 Mills, WY 307 266 6568 Seattle, WA 800 456 1415 New Orleans, LA 504 581 6151 The information contained in this publication is not intended to represent legal or tax advice and Oklahoma City, OK has been prepared solely for educational 405 232 0651 purposes. You may wish to consult your attorney or tax adviser regarding issues raised in this Overland Park, KS publication. 913 339 0800 13 Willis North America • 05/12