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Monthly Archives: August 2013

  • Preparing for 2014 Open Enrollment

    Posted on August 15, 2013

    Below is the link to the August 13, 2013 UBA Employer Webinar Series:  “Preparing for 2014 Open Enrollment”




    The heart of the Patient Protection and Affordable Care Act (PPACA) takes effect in 2014.  Even with the delay to the “play or pay” requirements, employers will need to make a number of changes to their plan designs.  Open enrollment for 2014 will bring many questions from employees about their options and obligations and additional required notifications.  To help plan sponsors understand what they need, and don’t need, to do, this webinar will cover:

    • New plan design requirements
    • Notices that should be included in your open enrollment packet (both new and ongoing)
    • A refresher on Summary of Benefits and Coverage requirements
    • Electronic distribution rules
    • Basic information on who is eligible to enroll in the exchanges/health insurance marketplace and who will be eligible for premium tax credits
    • The delay to the “play or pay” requirement, and how this affects employers



    Lisa M. deFilippis, Of Counsel – Jackson Lewis LLP

    Lisa M. deFilippis is Of Counsel in the Cleveland, Ohio office of Jackson Lewis LLP.  Ms. deFilippis is a member of the firm’s Employee Benefits Practice Group.  She has practiced employee benefits law for 25 years, advising a wide range of businesses and organizations in various industries.  Ms. deFilippis is experienced in all aspects of employee benefits law, including plan design, drafting, compliance, and fiduciary compliance issues.  She is a member of the Jackson Lewis healthcare reform task force.


    Melissa Ostrower, Of Counsel – Jackson Lewis LLP

    Melissa Ostrower is Of Counsel in the New York City office of Jackson Lewis LLP.  Ms. Ostrower advises companies on all aspects of employee benefits law, including compliance with ERISA and the Code as well as administrative matters and fiduciary issues relating to benefit plans.  Ms. Ostrower is a member of the Jackson Lewis healthcare reform task force and is intimately involved in helping Jackson Lewis clients ensure compliance with recently enacted healthcare reform legislation.


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    Please feel free to watch/listen to this whenever it is convenient for you and your staff. It will be available for you to view for the next 11 months. Your name and email are required for registration. There is no cost however this webinar has been approved for one credit hour toward PHR, SPHR and GPHR recertification through the HR Certification Institute. Once you have viewed the webinar, the last page will provide details on receiving the credit hour.

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  • A PPACA To-Do List- Why it’s necessary to have one..

    Posted on August 9, 2013

    The recent PPACA delays, while helpful in some ways, have erroneously caused many to think they can take a sigh of relief for a year.  PPACA is overhelming, confusing, and constantly changing, so most are more than likely not sure where to start.   PPACA requirements are also affected by employer size, which adds further confusion.  The best, effective approach for big tasks, such as PPACA compliance is to have a to-do checklist, especially in our environment where even something as seemingly simple as determining how many employees  you have is almost incomprehensible!  We have developed a PPACA Readiness Checklist that helps employers prepare for upcoming regulations, which outlines seven significant requirements, which include:

    1.     All plans that ended between Oct. 1, 2012 and Dec. 31, 2012 must pay the PCORI fee by July 31, 2013.

    2.     All employers covered by the Fair Labor Standards Act (FLSA) must provide a notice about the new health insurance marketplace (also called the affordable care exchange) by Oct. 1, 2013.

    3.     If the plan is not a calendar year plan, the employer should decide whether it will allow employees to make mid-year election changes to move from the plan to the exchange/marketplace, and/or to allow employees who previously declined coverage to enroll as of Jan. 1, 2014.  (The IRS recently delayed the individual shared responsibility requirement for individuals who are eligible for coverage under an employer-provided, non-calendar year group health plan to the start of the 2014 plan year, so obtaining coverage by Jan. 1, 2014 is not as urgent as previously thought. )

    5.     Although the employer shared responsibility/play or pay requirement has been delayed to 2015, employers should take advantage of this extra time to consider their options.  Employers with 50 or more full-time or full-time equivalent employees are considered “large” and will need to offer coverage or pay penalties.

    6.     If the employer is large enough that the shared responsibility requirements will apply in 2015, the employer needs to decide how it will determine which of its employees are “full-time” under PPACA.  An employee is considered “full-time” if he or she works an average of 30 or more hours per week.

    7.     If the employer is large enough for employer shared responsibility requirements to apply, the employer needs to decide whether it will offer coverage to its full-time employees, or pay penalties instead.


    For more information on the checklist and how you can make sure you are prepared for the PPACA, please feel free to contact our office at 207-761-2426.

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