Who is administering your COBRA? If it’s an insurance carrier they may not be administering all aspects of the eligible benefits. Read and make notes, better yet verify your COBRA plan is being properly administered. The fines for failing to do so can be staggering.

COBRA provides former employees, spouses, and dependent children the right to temporary continuation of health coverage at group rates. But you knew that. And most likely you know it covers dental and vision. However, did you know it covers EAP, GAP (group, not individual), Telemedicine, FSA and HRA plans?

The tricky administration comes FSA, the rules are based the 12-month plan year, which might not be the calendar year. If an employee has funds remaining in their FSA account at the end of the plan year they may not be able to use it in the next plan year. i.e. If the FSA is a December 1 to November 30 and an employee terminates on June 5, 2018, if they elected COBRA, that participation would end on November 30, 2018.

HRA accounts can also cause issues. HRA dollars must be available to COBRA participants. Employer’s may not like paying medical bills of former employees, it drives up their utilization rate.
Remember, COBRA was set up to protect employees, not employers.

Thanks to Susan Luskin, Diversified Administration, for her excellent CE class “If we have an Individual Mandate, why do we still need COBRA?” The above is a small, but important, part of her class.


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Association Health Plans – An update from the DOL

The DOL issued a new rule that allows employers to join together to offer group health insurance coverage. The rule allows association health plans to be formed based on industry or geography, such as by state, city, county, or multi-state metropolitan area.

The association health plans will be subject to the large group coverage nondiscrimination rules. These rules prohibit discrimination based on a health factor or within groups of similarly situated individuals. The rules however do provide plans to impose different eligibility provisions and costs based on employment-based classifications, full-time versus part-time.

These insurance plans would not be subject to requirements under the Affordable Care Act (ACA) which included mandatory coverage for a set of 10 essential health benefits, such as maternity and newborn care, prescription drug costs and mental health treatment. However, they are expected to be considerably less expensive than Obamacare plans. The warning from health providers, insurers and medical groups is the plans could drive up premiums by siphoning off healthy consumers who want cheaper coverage, leaving behind a sicker patient pool with higher medical costs in Obamacare plans.

States and the Federal government would share regulatory oversight of the plans, with states retaining their current authority.

Click here for more information from the DOL.


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

HealthKOS is Health in Your Hands

With a click of a button, patients have access to their health history from any mobile device and share it with physicians or patient care members.

HealthKos is a solution which shares information via automated interactions, within the patient care network. The processes optimizes medication use and care coordination. Health data points can be recorded and monitored for around the clock assistance. This includes all vital signs, weight and BMI, health wellness activities, and a complete updated medication list. The stored data on the HealthKOS platform allows for automated and timely communication with the health care team and family members to provide critical help in time of need, thus preventing an urgency from becoming an emergency, or even worse, an emergency from becoming a catastrophe.

HealthKOS empowers the patient to monitor their health through Bluetooth enabled devices and empowers the health care team to monitor patient progress outside the physician’s office, leading to timely interventions and preventing unnecessary disease progression and hospitalizations.

“Better Engagement → Leads to Better Compliance → Better Quality of Care”

HealthKOS, developed by doctors, allows the workflow to become patient centric, easy to use and provides lower cost quality health-care.


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Zocdoc: Find & Book Doctors

New to the area and don’t know anyone? Download the app and within 2 minutes find the perfect PCP, Specialist or Pediatrician. Zocdoc is the beginning of a new healthcare experience. Find doctors you love, read real reviews, book appointments instantly, and more with this award-winning app.

• See neighborhood doctors in your insurance network
• Book appointments with over 50 different medical specialties, including dentists, primary care doctors, allergists, OBGYNs, dermatologists, family doctors, urologists, psychologists, ophthalmologists, podiatrists, optometrists, pediatrists and more
• Read verified reviews from other patients
• See open appointment times and book instantly and keep track of your medical calendar. No phone calls necessary, even for same day bookings!
• Algorithm lets you search by specialties and conditions, like diabetes, obesity/weight loss, cancer, yellow eyes, bleeding, cysts, sore throat and more.
• Check in on the app to complete your paperwork and save time at the office
• Receive text reminders before your appointments

More Features
• Find doctors near your location with a convenient map
• Read doctors’ professional statements, learn about their education, and see what languages they speak
• Keep track of your physicians and easily schedule follow-up appointments from your Medical Team homepage
• Stay on top of important checkups with Wellness Reminders


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Rx Management – CoPay Accumulator Programs

With Accumulator Programs the manufacturer’s payments no longer count toward a patient’s deductible or out-of-pocket maximum. Employers and health plans could potentially save big money because accumulators shift a majority of drug costs to patients and manufacturers.

Normally, a manufacturer’s payments from a copay program count toward a patient’s deductible and annual out-of-pocket maximum. Once these annual limits are reached, the plan pays for all subsequent prescriptions.

Problem is the Accumulator Programs will lower a plan’s drug spending by discouraging the appropriate utilization of specialty therapies and reducing adherence.

You may recognize Copay Accumulator by other names; UnitedHealthcare uses the term “Coupon Adjustment: Benefit Plan Protection program,” Express Scripts uses the term “Out of Pocket Protection program.” Choose your poison, both are misleading, especially to the patient.

For a deep dive into the potential impact of CoPay Accumulator Programs I recommend reading the article (link below) from Adam J. Fein, Ph.D. (Drug Channels) that highlights many potential concerns to Copay Accumulator Programs. Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit


Update: Posted on April 27, 2018 

The Internal Revenue Service (IRS) has re-established $6,900 as the 2018 health savings account (HSA) contribution limit for individuals with family coverage under a high deductible health plan (HDHP).


Original Post on March 7, 2018

The IRS has announced the limits for HSAs have been revised for 2018. The adjustments are the result of changes made in the Tax Reform bill.

What changed? 

The annual HSA limit for family contribution went down from $6,900 to $6,850 and it is retroactively effective back to January 1st, 2018. The annual single limit of $3,450 remains unchanged.


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Pill Pack – Helping Employees Manage Medications

Taking multiple medications? Having trouble remembering what and when you took those medications? Looking for a simple solution? Statistics show 40M American adults take more than 5 prescriptions every day, but 50% don’t take their meds as prescribed.

PillPack is a service that can help. No need to sort medications, wait in line at the pharmacy or chase down refills. Every month PillPack will deliver your medications, including vitamins and OTC’s, sorted by dose. PillPack will automatically work with your doctors and process refills, regularly reviewing your medication schedule and manage your bills and claims – directly with your insurance!

You’ll always know what you owe. There are no hidden fees. Each month you’re responsible for your monthly co-pay, vitamins and over-the-counter medications.

Whether for yourself, caring for a parent, child, or friend, PillPack makes medication easy.

“Cadillac Tax” and Health Insurance Industry Fee Delayed in Spending Bill

A major victory in the continuing resolution that is keeping the federal government funded. The package included an additional two-year delay of the Cadillac Tax on employer-sponsored health insurance plans until 2022 and a moratorium in 2019 of the Health Insurance Tax on all plans.

Previously suspended for 2016 and 2017, the 2.3% excise tax on U.S. medical device revenues also restarted on Jan. 1, but will now remain suspended for two years through the end of 2019.


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

IRS will NOT accept 1040 without ACA Health Coverage Reporting

Employee Benefit Advisors recommends companies inform employees of the following. – The original announcement came out in October 2017, however EBA thought it would be a good reminder to post at this time.

Reminder: The new tax law does not actually repeal the individual mandate. It eliminates the penalty (penalty is zero) starting in 2019, not 2017 or 2018. However, the penalty can be reinstated with an update to the tax law.   The requirement for companies with 50+ FTEs to offer health insurance remains.


The IRS has stated that it will not accept Forms 1040 for the 2017 tax year if the taxpayer does not report on the ACA’s health coverage reporting requirements. This is the first year that the IRS has put in place system changes to its Form 1040 review process that would reject tax returns during processing in instances where the taxpayer does not provide this information.

Background. The ACA’s individual mandate requires most individuals to obtain minimum essential health insurance coverage for themselves and any dependents or pay a penalty. Form 1040 instructs taxpayers to report whether they (and every dependent listed on their return) had health insurance coverage, were eligible for an exemption from the ACA’s coverage requirement, or will make an individual shared responsibility payment.

For prior tax seasons, the IRS had delayed processing of tax returns that did not answer the health care coverage questions, but it did not prevent the return from ultimately being processed.

Guidance. For 2017 tax returns, the IRS has stated it will not accept the electronic tax return until the taxpayer indicates whether they (and all of their dependents) met the ACA requirements or are paying the penalty. In addition, returns filed on paper that do not address the ACA reporting requirements may be suspended pending the receipt of additional information, and refunds may be delayed.

In response to the IRS’s revised review process for Forms 1040, to avoid refund and processing delays when filing 2017 tax returns, taxpayers should indicate whether they (and everyone listed as dependents on their tax return) had health insurance coverage, qualified for an exemption or made a shared responsibility payment.

The IRS guidance is available at:


Content is provided for information purposes by The Wagner Law Group and may not be relied upon as specific legal advice.

IRS Guidelines – Indexed for 2018

Social Security Tax is 6.2% on income up to $128,400 up from $ 127,200
Medicare Tax unlimited 1.45% to Unlimited

High Deductible Health Plans
Minimum Annual Deductible (Individual/Family) $1,350 / $2,700
Maximum Out-of-Pocket Limit (Individual/Family) $6,650 / $13,300

Health Savings Accounts
Individual / Family $3,450 / $6,900 IRS announced change to $6,850 March 5, 2018
Catch-up Contribution $1,000

Flexible Spending Accounts
Health Care Flexible Spending Account Maximums $2,650
Dependent Care Spending Account Maximum $5,000

Mileage & Transportation
Standard Mileage Rates
54.5 cents per mile for business miles driven
18 cents per mile for medical or moving purposes
14 cents per mile driven in service of charitable organizations

Parking (monthly) $260
Mass Transit Passes (monthly) $260

Compensation Limit $275,000
Highly Compensated Employee Salary Amount $120,000
Annual Compensation for Key Employee $175,000
Defined Benefit Plan Limit $220,000
Defined Contribution Plan Limit $55,000

Retirement Plans
401(k) $18,500
401(k) Catch-up $6,000
403(b) $18,500
457(b)(2) and 124(c)(1) $18,500
457(b) Catch-up $6,000
IRA Limit $5,500/$6,500 for age 50+
Simple IRA Limit $12,500/$3,000 Catch-Up


Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

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