Taking control of health care expenses is on the top of most people’s to-do list for 2018.  The average premium increase for 2018 is 18% for Affordable Care Act (ACA) plans.  So, how do you save money on health care when the costs seems to keep increasing faster than wage increases?  One way is through medical savings accounts.

Medical savings accounts are used in conjunction with High Deductible Health Plans (HDHP) and allow savers to use their pre-tax dollars to pay for qualified health care expenses.  There are three major types of medical savings accounts as defined by the IRS.  The Health Savings Account (HSA) is funded through an employer and is usually part of a salary reduction agreement.  The employer establishes this account and contributes toward it through payroll deductions.  The employee uses the balance to pay for qualified health care costs.  Money in HSA is not forfeited at the end of the year if the employee does not use it. The Health Flexible Savings Account (FSA) can be funded by the employer, employee, or any other contributor.  These pre-tax dollars are not part of a salary reduction plan and can be used for approved health care expenses.  Money in this account can be rolled over by one of two ways: 1) balance used in first 2.5 months of new year or 2) up to $500 rolled over to new year.  The third type of savings account is the Health Reimbursement Arrangement (HRA).  This account may only be contributed to by the employer and is not included in the employee’s income.  The employee then uses these contributions to pay for qualified medical expenses and the unused funds can be rolled over year to year.

There are many benefits to participating in a medical savings account.  One major benefit is the control it gives to employee when paying for health care.  As we move to a more consumer driven health plan arrangement, the individual can make informed choices on their medical expenses.  They can “shop around” to get better pricing on everything from MRIs to prescription drugs.  By placing the control of the funds back in the employee’s hands, the employer also sees a cost savings.  Reduction in premiums as well as administrative costs are attractive to employers as they look to set up these accounts for their workforce.  The ability to set aside funds pre-tax is advantageous to the savings savvy individual.  The interest earned on these accounts is also tax-free.

The federal government made adjustments to contribution limits for medical savings accounts for 2018.  For an individual purchasing single medical coverage, the yearly limit increased $50 from 2017 to a new total $3450.  Family contribution limits also increased to $6850 for this year.  Those over the age of 55 with single medical plans are now allowed to contribute $4450 and for families with the insurance provider over 55 the new limit is $7900.

Health care consumers can find ways to save money even as the cost of medical care increases.  Contributing to health savings accounts benefits both the employee as well as the employer with cost savings on premiums and better informed choices on where to spend those medical dollars.  The savings gained on these accounts even end up rewarding the consumer for making healthier lifestyle choices with lower out-of-pocket expenses for medical care.  That’s a win-win for the healthy consumer!

Our February 1, 2018 blog post reported on the late February release of the Form W-4 and guidance on the income withholding rules that changed under the Tax Cuts and Jobs Act. On February 28, 2018, the federal Internal Revenue Service (IRS) released the new 2018 Form W-4 and an updated withholding calculator.

Why a Withholding Calculator?

The IRS encourages the use of the withholding calculator for a quick paycheck checkup in light of the changes to the tax law for 2018. According to the IRS, employees may be encouraged to use the calculator to ensure the correct tax amount is being withheld from their paychecks. For example, reviewing withholding may help protect employees against having too little tax withheld and facing an unexpected tax bill or penalty during next year’s tax season. Alternatively, with the average refund being $2,800, the IRS anticipates that some employees may have less tax withheld up front and instead receive more in their paychecks. If an employee needs to make changes to his or her withholding, the calculator provides the necessary information to fill out a new W-4.

Next Steps

Make sure your employees know about the availability of the calculator. Only employees changing their withholding need to complete a new W-4, and they may use results from the calculator to complete the new form. Encourage those employees to submit updated W-4s as soon as possible to ensure their withholdings are accurate.

The IRS also suggests that if employees follow the calculator’s recommendations and change their 2018 withholding, they should recheck their withholding at the beginning of 2019 to protect against having too little withheld. This is important where an employee reduces his or her withholding sometime during 2018 because a mid-year withholding change in 2018 may have a different full-year impact in 2019.

Originally Published By ThinkHR.com

This year’s flu season is a rough one. Although the predominant strains of this year’s influenza viruses were represented in the vaccine, they mutated, which decreased the effectiveness of the immunization. The flu then spread widely and quickly, and in addition, the symptoms were severe and deadly. The U.S. Centers for Disease Control and Prevention (CDC) reported that the 2017 – 2018 flu season established new records for the percentage of outpatient visits related to flu symptoms and number of flu hospitalizations.

Younger, healthy adults were hit harder than is typical, which had impacts on the workplace. In fact, Challenger, Gray & Christmas, Inc. recently revised its estimates on the impact of this flu season on employers, raising the cost of lost productivity to over $21 billion, with roughly 25 million workers falling ill.

Fortunately, the CDC is reporting that it looks like this season is starting to peak, and while rates of infection are still high in most of the country, they are no longer rising and should start to drop. What can you do as an employer to keep your business running smoothly for the rest of this flu season and throughout the next one?

  1. Help sick employees stay home. Consider that sick employees worried about their pay, unfinished projects and deadlines, or compliance with the company attendance policy may feel they need to come to work even if they are sick. Do what you can to be compassionate and encourage them to stay home so they can get better as well as protect their co-workers from infection. In addition, make sure your sick leave policies are compliant with all local and state laws, and communicate them to your employees. Be clear with the expectation that sick employees not to report to work. For employees who feel well enough to work but may still be contagious, encourage them to work remotely if their job duties will allow. Be consistent in your application of your attendance and remote work rules.
  2. Know the law. Although the flu is generally not serious enough to require leaves of absence beyond what sick leave or PTO allow for, in a severe season, employees may need additional time off. Consider how the federal Family and Medical Leave Act (FMLA), state leave laws, and the Americans with Disabilities Act (ADA) may come into play for employees who have severe cases of the flu, complications, or family members who need care.
  3. Be flexible. During acute flu outbreaks, schools or daycare facilities may close, leaving parents without childcare. Employees may also need to be away from the workplace to provide care to sick children, partners, or parents. Examine your policies to see where you can provide flexibility. Look for opportunities to cross-train employees on each other’s essential duties so their work can continue while they are out.
  4. Keep it clean. Direct cleaning crews to thoroughly disinfect high-touch areas such as doorknobs, kitchen areas, and bathrooms nightly. Provide hand sanitizer in common areas and encourage frequent handwashing. Keep disinfecting wipes handy for staff to clean their personal work areas with.
  5. Limit exposure. Avoid non-essential in-person meetings and travel that can expose employees to the flu virus. Rely on technology such as video conferencing, Slack, Skype, or other platforms to bring people together virtually. Consider staggering work shifts if possible to limit the number of people in the workplace at one time.
  6. Focus on wellness. Offer free or low-cost flu shots in the workplace. If your company provides snacks or meals for employees, offer healthier options packed with nutrients.

Get it all

AGENCY RESOURCES: Get the latest weekly flu stats from the CDC. Learn more about how the FMLA and ADA may be used during pandemic flu from the U.S. Department of Labor.

By Rachel Sobel

Originally published by www.ThinkHR.com

Have you ever heard the proverb “Knowledge is power?” It means that knowledge is more powerful than just physical strength and with knowledge people can produce powerful results. This applies to your annual medical physical as well! The #1 goal of your annual exam is to GAIN KNOWLEDGE. Annual exams offer you and your doctor a baseline for your health as well as being key to detecting early signs of diseases and conditions.

According to Malcom Thalor, MD, “A good general exam should include a comprehensive medical history, family history, lifestyle review, problem-focused physical exam, appropriate screening and diagnostic tests and vaccinations, with time for discussion, assessment and education. And a good health care provider will always focus first and foremost on your health goals.”

Early detection of chronic diseases can save both your personal pocketbook as well as your life! By scheduling AND attending your annual physical, you are able to cut down on medical costs of undiagnosed conditions. Catching a disease early means you are able to attack it early. If you wait until you are exhibiting symptoms or have been symptomatic for a long while, then the disease may be to a stage that is costly to treat. Early detection gives you a jump start on treatments and can reduce your out of pocket expenses.

When you are prepared to speak with your Primary Care Physician (PCP), you can set the agenda for your appointment so that you get all your questions answered as well as your PCP’s questions. Here are some tips for a successful annual physical exam:

  • Bring a list of medications you are currently taking—You may even take pictures of the bottles so they can see the strength and how many.
  • Have a list of any symptoms you are having ready to discuss.
  • Bring the results of any relevant surgeries, tests, and medical procedures
  • Share a list of the names and numbers of your other doctors that you see on a regular basis.
  • If you have an implanted device (insulin pump, spinal cord stimulator, etc) bring the device card with you.
  • Bring a list of questions! Doctors want well informed patients leaving their office. Here are some sample questions you may want to ask:
    • What vaccines do I need?
    • What health screenings do I need?
    • What lifestyle changes do I need to make?
    • Am I on the right medications?

Becoming a well-informed patient who follows through on going to their annual exam as well as follows the advice given to them from their physician after asking good questions, will not only save your budget, but it can save your life!

Do you offer health coverage to your employees? Does your group health plan cover outpatient prescription drugs? If so, federal law requires you to complete an online disclosure form every year with information about your plan’s drug coverage. You have 60 days from the start of your health plan year to complete the form. For instance, for a calendar-year health plan, this year’s deadline is March 1, 2018.


The Centers for Medicare and Medicaid Services (CMS) is a federal agency that collects data and administers various federal programs. The agency utilizes the CMS online tool to collect information from employers about whether their group health plan’s prescription drug coverage is creditable or noncreditable. Creditable coverage means the group health plan’s prescription drug coverage is actuarially equivalent to Medicare’s Part D drug plans. In other words, the group plan is considered creditable if its drug benefits are as good as or better than Medicare’s benefits.

To confirm whether your plan provides creditable or noncreditable coverage, check with the plan’s carrier or HMO (if insured) or the plan’s actuary (if self-funded). CMS provides guidance to help plan sponsors, carriers, and actuaries determine the plan’s status.

Deadline for Disclosure

All group health plans that include any outpatient prescription drug benefits, regardless of whether the plan is insured, self-funded, grandfathered, or nongrandfathered, must complete the CMS disclosure requirement. There is no exception for small employers.

Complete the CMS online disclosure form every year within 60 days of the start of the plan year. For instance, for calendar-year plans, this year’s deadline is March 1, 2018.

Additionally, if your plan terminates or its status changes between creditable and noncreditable coverage, you must disclose the updated information to CMS within 30 days of the change.

Completing the Disclosure Form

The CMS online tool is the only method allowed for completing the required disclosure. From this link, follow the prompts to respond to a series of questions regarding the plan. The link is the same regardless of whether the employer’s plan provides creditable or noncreditable coverage.

The entire process usually takes only 5 or 10 minutes to complete. To save time, have the following information handy before you start filling in the form:

  • Information about the plan sponsor (employer): Name, address, phone number, and federal Employer Identification Number (EIN).
  • Number of prescription drug options offered (e.g., if employer offers two plan options with different benefit levels, the number is “2”).
  • Creditable/Noncreditable Offer: Indicate whether all options are creditable or noncreditable or whether some are creditable and others are noncreditable.
  • Plan year beginning and ending dates.
  • Estimated number of plan participants eligible for Medicare (and how many are participants in the employer’s retiree health plan, if any).
  • Date that the plan’s Notice of Creditable (or Noncreditable) Coverage was provided to participants.
  • Name, title, and email address of the employer’s authorized individual completing the disclosure.

We suggest you print a copy of the completed disclosure to keep for your records.

Note: Employers that receive the Retiree Drug Subsidy (RDS), or sponsor health plans that contract directly with one or more Medicare Part D plans, should seek the advice of legal counsel regarding the applicable disclosure requirements.

Additional Disclosure Requirement

Separate from the CMS online disclosure requirement, employers also must distribute a disclosure notice to Medicare-eligible group health plan participants. The deadline for distributing the participant notice is October 14 of the preceding year. It often is difficult for employers to identify which employees and spouses may be Medicare-eligible, so most employers simply distribute the notice to all participants regardless of age or status. For information about the notice requirement, see our previous post.


Originally Published By ThinkHR.com

IRS Releases Publication 15 and W-4 Withholding Guidance for 2018

On January 31, 2018, the federal Internal Revenue Service (IRS) released Publication 15 — Introductory Material, which includes the following:

  • 2018 federal income tax withholding tables.
  • Exempt Form W-4.
  • New information on:
    • Withholding allowance.
    • Withholding on supplemental wages.
    • Backup withholding.
    • Moving expense reimbursement.
    • Social Security and Medicare tax for 2018.
    • Disaster tax relief.

Read Publication 15 and further details here.

EEOC Penalty Increases for Failure to Post Required Notices

On January 18, 2018, the U.S. Equal Employment Opportunity Commission (EEOC) released a final rule increasing the penalty amount from $534 to $545 for violations of Title VII of the Civil Rights Act (Title VII), the Americans with Disabilities Act (ADA), and the Genetic Information Nondiscrimination Act (GINA) notice posting requirements.

The final rule is effective February 20, 2018.

Originally Published By ThinkHR.com

If you’ve been getting questions from your employees about completing new 2018 W-4 forms to take advantage of the tax reform rules, we’ve finally received some answers. You can continue to rely on the current W-4 forms for now until the new 2018 form is released in late February.

The January 29th Internal Revenue Service (IRS) Notice 2018-14 provides additional guidance on the income withholding rules that were changed under the recently passed Tax Cuts and Jobs Act. The guidance:

  • Extends the effective period of Forms W-4 furnished to claim exemption from withholding for 2017 until February 28, 2018.
  • Permits employees to claim exemption from withholding for 2018 by temporarily using the 2017 Form W-4. This procedure will expire 30 days after the 2018 Form W-4 is released.
  • States that employees experiencing a change in status that causes a reduction in the number of withholding exemptions are not required to furnish employers with new withholding certificates until 30 days after the 2018 Form W-4 is released.
  • Provides that employees who have a reduction in the number of withholding allowances solely due to changes made by the Tax Cuts and Jobs Act are not required to furnish employers with new withholding certificates during 2018. However, employees may choose to update their withholding at any time in response to the act. Employees who choose to update their withholding may use the 2017 Form W-4 instead of the 2018 Form W-4 to report changes in withholding allowances until 30 days after the 2018 Form W-4 is released.
  • Confirms that the optional withholding rate on supplemental wage payments is 22 percent for 2018 through 2025.
  • Specifies that, for 2018, withholding under IRC 3405(a)(4) on periodic payments when no withholding certificate is in effect will be based on treating the payee as a married individual claiming three withholding allowances.

In addition to the guidance, the IRS also released a new Publication 15, (Circular E), Employer Tax Guide, for 2018. Publication 15 includes the 2018 withholding tables and explains an employer’s tax responsibilities, such as withholding, depositing, reporting, paying, and correcting employment taxes.


Originally Published By ThinkHR.com

As the first month of 2018 wraps up, companies have already begun the arduous task of submitting budgets and finding ways to cut costs for the new year. One of the most effective ways to combat increasing health care costs for companies is to move to a Self-Funded insurance plan. By paying for claims out-of-pocket instead of paying a premium to an insurance carrier, companies can save around 20% in administration costs and state taxes. That’s quite a cost savings!

The topic of Self-Funding is huge and so we want to break it down into smaller bites for you to digest. This month we want to tackle a basic introduction to Self-Funding and in the coming months, we will cover the benefits, risks, and the stop-loss associated with this type of plan.


  • When the employer assumes the financial risk for providing health care benefits to its employees, this is called Self-Funding.
  • Self-Funded plans allow the employer to tailor the benefits plan design to best suit their employees. Employers can look at the demographics of their workforce and decide which benefits would be most utilized as well as cut benefits that are forecasted to be underutilized.
  • While previously most used by large companies, small and mid-sized companies, even with as few as 25 employees, are seeing cost benefits to moving to Self-Funded insurance plans.
  • Companies pay no state premium taxes on self-funded expenditures. This savings is around 5% – 3/5% depending on in which state the company operates.
  • Since employers are paying for claims, they have access to claims data. While keeping within HIPAA privacy guidelines, the employer can identify and reach out to employees with certain at-risk conditions (diabetes, heart disease, stroke) and offer assistance with combating these health concerns. This also allows greater population-wide health intervention like weight loss programs and smoking cessation assistance.
  • Companies typically hire third-party administrators (TPA) to help design and administer the insurance plans. This allows greater control of the plan benefits and claims payments for the company.

As you can see, Self-Funding has many facets. It’s important to gather as much information as you can and weigh the benefits and risks of moving from a Fully-Funded plan for your company to a Self-Funded one. Doing your research and making the move to a Self-Funded plan could help you gain greater control over your healthcare costs and allow you to design an original plan that best fits your employees.

Do I need life insurance once I retire? Just because you’re retired doesn’t necessarily mean you’re financially sound.

Think of all the different scenarios that may still be applicable: You may have been required to retire early; you may have had investments that have gone sour and haven’t had time to rebuild your nest egg. Additionally, there may be a need to cover final expenses, you may have children still at home who depend on the them, or you may have a family member like an aging parent or special-needs sibling that you provide financial support for.

The bottom line is this: If you owe someone, love someone, or someone depends on on you financially, you need life insurance. And just because you’re retired or old doesn’t mean those three things go away.

Do I need the same amount of life insurance coverage as I did before? If you bought the life insurance to replace income and have built up their investments, maybe not.

Then again, if you have built up their investments over the years, there may be some state or federal inheritance tax that will have to be paid upon their death. And even if there is no federal tax, there may still be significant state inheritance tax. There are also things like probate costs, administration costs; there might be final debt or a mortgage on house, too. So as long as there is some type of financial exposure, you need life insurance to match up with that.

If I don’t have one, is it still possible to buy a policy in retirement? Absolutely. Just because you’re old or older doesn’t mean you’re uninsurable.

I just got a call from someone doing planning for the family patriarch who’s 85 years old. They realized that right now, the estate is worth more than the combined amount of federal exemption and that there will be tax to pay. That’s where life insurance comes in, at less than a dollar for each dollar of tax.

Another reason to have the coverage is if someone has taken 100% pay-out on their pension, with no survivorship provision. If that person dies, no money gets paid out to the surviving spouse. This is more common than you think. Nor is it unusual to hear that someone remarries and forgets to change the pension beneficiary. Life insurance can ensure that the spouse is taken care of.

What else should I know about having life insurance in retirement? People don’t often talk about the living benefits of life insurance.

Let’s say you no longer need the death benefit, but are living with a lingering, terminal illness and may not have sufficient cash to pay medical expenses. The accelerated death benefit provision means you can go to the insurance company and pull down money from the policy to absorb the costs of that illness and avoid bankruptcy.

A permanent life insurance policy is also a place to put money aside that gives you a better rate of return than a low pay-out CD or putting money in a safely deposit box. It’s a way to have some safe money invested at no risk—it’s just there for when you need it.

By Marvin H. Feldman
Originally Published By LifeHappens.org

Kathy! You are amazing! I was speaking with Dr. Abel today re a patient and on his own he brought up how you were able to fix his wife and daughter’s insurance in less than 24 hours AND you were so NICE and PROFESSIONAL. He then said you were AMAZING. I absolutely love working with you, Ron, and the entire gang! Just wanted to pass this on - and again thank you for all you do for us!!!!

- Office Manager, Surgical Center in San Francisco