Human Resources

Pre-Active Medicine – CompanionDx

Anywhere between 40 and 75 percent of drugs are ineffective for individual patients. That means a large portion of patients may not only be wasting their money—but they may not be receiving the treatment or the results they seek.

Pre-Active medicine is a new diagnostic discipline that uses genetic insights to help prevent adverse drug reactions, misdiagnosis or other negative consequences of inadequate medical discovery.

CompanionDx™ is one of the only providers of both pharmacogenomics evaluations and cancer companion diagnostic testing. When used separately or in conjunction, these two types of tests are giving physicians the resources they need for more comprehensive patient treatment profiles—and that means more certainty when it comes to effective therapeutic decisions.

Tests include:
Pharmacogenomics testing
Cancer companion diagnostics testing
Colorectal cancer screening
NextGen Sequencing testing (in development)
 
You’ll receive easy-to-read test reports within 3-7 days.

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

ACA 2015 Tax Forms 1094 and 1095

The ACA forms chart is voluntary for employers that wish to file in 2015 for 2014. The return and transmittal forms are to be filed with the IRS on or before February 28 (March 31 if filed electronically) of the year following the calendar year of coverage.

Here’s the IRS link for complete instructions.
http://tinyurl.com/mgzhyoc

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

ACA: Employer Mandate Tree

The employer mandate tree easily breaks down what we see today and the changes taking place next year.

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

Your HSA Contributions May Trigger Cadillac Tax

The Cadillac Tax is coming in 2018. – All “premiums” over the designated amounts, currently set at $10,200 for single coverage and $27,500 for family coverage, will be taxed at 40%.

BUT, the IRS and DOL are currently counting employee contributions into their own HSA’s as “premiums”.

So, if you are being a responsible healthcare consumer, choosing a high deductible plan and putting dollars into an account in order to pay medical expenses, those dollars, if pre-taxed in an employer’s Section 125 Plan, will now count against you!

If the IRS does adopt rules requiring employers to include employees’ pretax HSA contributions in calculating plan costs, employers are likely to redesign their high-deductible plans, such as capping pretax contributions or allowing only after-tax contributions to reduce the likelihood of triggering the excise tax.

Thanks to Susan Luskin, FLMI, CLU, CEBS, RHU, ChHC, Diversified Administration Inc, www.Div125.com, for pointing this out.

“Embedded” Out-of-Pocket Maximum Rule Clarified

HHS recently finalized regulations to verify the annual out-of-pocket maximums for an individual in 2016 are limited to the annual limit for self-only coverage. This applies to all individuals, including each individual under family coverage. The regulation provides that the embedded out-of-pocket limit applies to all plans.

This embedded rule means that plans (including self-funded plans) will now have to have embedded out-of-pocket limits for each individual covered under family coverage. For example, using the 2016 limits, if a family plan has an annual out-of-pocket limit of $12,000 and one family member incurs an expense of $25,000, that family member would be responsible for expenses up to $6,850 (the self-only out-of-pocket limit), and the remaining $18,150 would be paid in full by the plan. Additional expenses incurred by that family member would be paid by the plan with no cost sharing for the remainder of the plan year.

 

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

Tower of Babel teaches valuable lesson

Gen 11:1-6 Now the whole world had one language…as one people speaking the same language…then nothing they plan to do will be impossible for them.

PPACA requires group health plans to provide both a Summary of Benefits and Coverage (SBC), and a Glossary of Health Coverage and Medical Terms in a culturally and linguistically appropriate manner. When populations speaking Spanish, Chinese, Tagalog or Navajo reach 10 percent of the population in a county, federal regulations require translation.

‘When in Rome, do as the Romans do.’ – Think of the possibilities.

Follow this link to review an updated list of counties where translation is required.  

IRS Guidelines – Indexed Figures for 2015

FICA
Social Security 6.2% to $118,500
Medicare unlimited 1.45% to Unlimited

High Deductible Health Plans
Minimum Annual Deductible (Individual/Family) $1,300 / $2,600
Maximum Out-of-Pocket Limit (Individual/Family) $6,450 / $12,900

Health Savings Accounts
Individual / Family $3,350 / $6,650
Catch-up Contribution $1,000

Flexible Spending Accounts
Health Care Flexible Spending Account Maximums $2,550
Dependent Care Spending Account Maximum $5,000

Mileage & Transportation
Standard Mileage Rate
57.5 cents per mile for business miles driven
0.23 cents per mile for medical or moving purposes
14 cents per mile driven in service of charitable organizations
Parking (monthly) $250
Mass Transit Passes (monthly) $130
Bicycle Commuting (monthly) TBD – 2014 amount was $20

Compensation
Compensation Limit $265,000
Highly Compensated Employee Salary Amount $120,000
Annual Compensation for Key Employee $170,000
Defined Benefit Plan Limit $210,000
Defined Contribution Plan Limit $53,000

Retirement Plans
401(k) $18,000
401(k) Catch-up $6,000
403(b) $18,000
457(b)(2) and 124(c)(1) $18,000
457(b) Catch-up $6,000

Useful Website: healthgrades

The website, www.healthgrades.com, allows individuals to search for a doctor based on name, specialty, condition, procedure, and/or geographic location. Users can filter results by many options including Insurance Provider. While the home page does not have a field to input insurance, once you enter a search (see screen shot below), on the far right you will see an “other criteria” section where a consumer can filter by insurance carrier. However, If you input a specific provider the insurance accepted is hard to find. It is buried under phone and address – you need to scroll to the bottom of the page.

Caveat: Be sure to check with the provider that they are in-network. i.e. They may be listed as accepting Blue Cross Blue Shield of Florida, however BCBS-FL has three different networks; BlieOptions, BlueCare and BlueSelect. The site does not give you a carrier’s specific network choice. (The company tells me they are looking to add plan level detail to in the future.)

2015 HSA Contribution Limits

A health savings account (HSA) is a tax-advantaged savings account available to those who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent. HSAs are owned by the individual.

HSA 2015 annual contribution limits
HSA annual contributions limits – Single $3,350 / Family $6,650
HSA catch-up contributions – $1,000 for an accountholder age 55 or older

2015 Plan Design Requirements
Minimum deductible  –   Single $1,300 / Family $2,600
Maximum out-of-pocket expenses – Single $6,350 / Family $12,700

(Other HSA-eligibility criteria apply including: cannot be enrolled in Medicare, have received VA medical benefits in the past three months, or be eligible to be claimed as a dependent on someone else’s tax return.)

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