Is Your Healthcare Plan Covering People It Shouldn’t?

healthcare eligibilityIf you provide an employer healthcare plan, it’s vital to ensure only the correct people are covered. Comprehensive healthcare insurance is one of the most important benefits you provide to employees, so keeping premiums down matters to everyone.

One of the main causes of rising premiums and healthcare costs is when ineligible people continue to be covered on a healthcare plan. For employer-provided health insurance, ineligible people are typically:

  • Former employees who have now left your business.
  • Employees whose status has changed, meaning they are no longer eligible under the plan, or should be on a different plan.
  • Dependents of an employee, where the status of the dependent has changed.

Examples of ineligible people for a healthcare plan

The following situations could all cause people to become ineligible.

  • A dependent child who ages beyond the dependent eligibility requirements in the plan.
  • A former spouse who separated from your employee.
  • An employee who leaves your business.
  • An employee whose status has changed, for example through changing the number of hours worked or moving to a different position, and whose new status requires a different healthcare plan.

Creating a healthcare eligibility audit

You need a process to understand and remove people from your employer-provided healthcare plan. Here’s how to put an “Employee and dependent healthcare eligibility audit” together.

Understand the eligibility requirements of your current employer-provided healthcare plans

Go through any existing employer-provided plans and note down:

  • All employees currently covered by the plan.
  • All dependents currently covered by the plan.
  • Eligibility requirements for employees.
  • Eligibility requirements for employee dependents.
  • Benefits and coverage provided.

You may hold this information internally, or you can get the data from your broker or healthcare insurance provider.

Analyze your existing employee data

Match your existing employee data against the healthcare plan eligibility requirements. Check:

  • Any employee listed as being on the plan is still employed by you.
  • Any dependent listed on the plan is still a dependent on the employee.
  • The type of healthcare plan is appropriate for the status of the employee.
  • All eligibility requirements are being met by any active plan participants.

Find gaps in the data

It’s likely that you will find gaps in the information. You may not have the latest details of dependents or employees. Complete a gap analysis to understand the data you need to ensure only appropriate people are covered by the plan.

Carry out a healthcare eligibility audit to close any gaps

Once you know what data you need, you will need to audit the information with your employees. Approach each employee with the details of their health insurance for them and their dependents and ask if all the information is factual and correct. If it is, get them to sign off on the information.

If the data is incorrect, get it updated and see how it affects healthcare eligibility. Communicate this back to the employee.

Careful communication is key

You will need to communicate carefully throughout this process. Employees may see the eligibility audit as a tool for taking away healthcare coverage. It’s important to manage the message carefully — The audit ensures only appropriate, eligible people are covered. That means less cost-leakage and medical expenses on plans, which keeps premiums down and ensures the right people have the right coverage.

You may want to complete the healthcare eligibility audit every year. This will ensure your records are up to date and reduce the premiums you and your employees need to spend.

Jill Goulet
Risk Management Consultant

healthcare eligibility

Millennials and Healthcare — What Are They Looking For?

MillenialsAs the fastest-growing generational group, millennials (people born between the mid-1980s and the turn of the century) are a vital part of a strong workforce. If you want to attract millennials to your business, it’s important to understand what they need and more importantly, what they want.

In addition to a good salary and a positive work environment, the benefit millennials are most interested in is healthcare. In fact, since the Affordable Care Act came into force, the number of uninsured millennials has fallen from 23% to just 11%. Insured millennials are better for your business too — Insured millennials are more likely to report being in good or excellent health (79%) than uninsured millennials (62%).

With health insurance being front and center, and increasing options for employment, how do you attract and retain the best young talent? An important part is providing the right health benefits. Let’s explore a few options.

The health services millennials are most interested in

It’s important to provide health insurance plans to cover the main concerns millennials have about their health, this includes:

  • Accident and emergency coverage — Catastrophe can strike at any time. Millennials are less concerned with insurance against long-term, chronic illnesses than they are against accidents and other critical emergencies. A health plan that has good coverage for emergency room visits and treating acute conditions fits in well with their needs.
  • Doctor visits — Reasonable copay amounts for doctor and specialist visits rank highly with millennials.
  • Immunizations and wellness — Staying healthy is near the top of the millennial’s agenda. This includes vaccination for flu and human papillomavirus vaccine (HPV). wellness programs also play a part in helping to keep people healthy and reduce stress.
  • Alcohol and depression screening and counselling — Depression, anxiety and other mental illness affects a disproportionate number of young people. Access to therapy, treatment, and counsellors is critically important.
  • Sexual and reproductive health — Contraception, birth control, and sexual health are vital to millennials. Pregnancy, birth, breastfeeding support, and infant care are also high on the agenda for millennials wanting to start families.

 Keeping health premium costs down for millennials

Another important consideration is the cost of premiums, and the trend here is clear — Millennials much prefer low-premium, high-deductible health plans. For many millennials, cost is the most important factor when it comes to health insurance. In fact, two thirds of them said a premium of more than $200 a month is unaffordable. Clearly, with a premium that low, high-deductible plans are really the only choice.

Another option is to give millennials various options in terms of their overall benefits package — Perhaps they can trade off some vacation days for a lower insurance premium?

Addressing other health concerns

It’s not just premiums and coverage that are important to millennials. Many are concerned that being ill or injured for an extended period of time would mean they would get fired. Make sure you have clear employment policies in place that address these concerns — What are implications for someone’s employment if they are unable to work for the medium or long-term?

Another benefit you can offer is making it easier for millennials to transfer off of their family health plan. Children can stay on their parent’s plan until they’re 26 years old, so providing a convenient and easy way to switch will definitely help.

Make it clear that the Affordable Care Act requires everyone to be insured by law. Being uninsured just isn’t an option unless they want to pay yearly fines when they report their taxes. Clearly explain the benefits of health insurance and make it easy for people to start paying their premiums and enjoying their coverage.

Jill Goulet
Risk Management Consultant

Sinclair 7-22-15-14

Why medium-sized groups should steer clear of the Obamacare marketplace

affordable care actWhile the Affordable Care Act has helped over 20 million people get health insurance, it’s not always the best choice. Although it’s been a tremendous asset to millions of self-employed, part-time employees, and others who weren’t covered before, it’s not always right for employers. If you’re a medium-sized (or larger) employer or administering a medium-sized or bigger group, Obamacare isn’t for you. Here’s why.

An inconsistent approach to health plans

There are dozens of plans available on the ACA marketplace. Although this choice is a great thing for individuals, when it comes to understanding and implementing this across your business, it’s going to be an administrative nightmare.

There’s a huge variance in the types of plans, benefits, premiums, copays and deductibles offered by all the different plans and insurers. Combine this with confusion over networks and coverage, and your HR department will spend much of their time just trying to understand the myriad differences.

If you can offer your employees a simple and defined set of health insurance plans, it’s much easier for them to get the right information and understand all of the various benefits and payments they need to make for health insurance coverage. This means less confused, happier employees.

Obamacare may not offer the most cost effective plans

Premiums for ACA marketplace plans have been increasing year on year, and subsidies vary depending on an employee’s income. This combination of variable premiums and subsidies means an employee may not necessarily be getting the best deal through the open marketplace.

A dedicated health insurance broker can negotiate prices on health insurance plans on your behalf, and pass the cost savings onto you and your employees. If you’re employing more than a few employees, you can get good discounts for “economies of scale.”

You’ll lose your free health insurance broker

Don’t underestimate the value a good health insurance broker can provide. As experts in health insurance they can:

  • Provide helpful information to you and your employees.
  • Answer any questions about health insurance, premiums, and coverage.
  • Work closely with your HR department to give employees the information they need.
  • Negotiate better prices with insurers on your behalf.

Increased worry and confusion among your employees

No one wants to spend too long worrying about their health plan. Most people just want to know they’re properly covered, that their premiums are reasonable, and that their health will be taken care of. When you offer a clear and defined set of health insurance plans, that makes things easier for everyone. The combination of a single point of contact in HR, proper information about health insurance, and support from a broker, gives your employees the confidence they need.

As you can see, the combination of a simple and consistent approach to health insurance is better for you and your people. When you combine that with better pricing, expert support, less administration, and more confident employees, it just makes sense to talk to your health insurance broker. They’ll help you decide which plans are best for your people, and give you the service and expertise you and they need to make an informed choice.

Jill Goulet
Risk Management Consultant

Sinclair 7-22-15-14


Changes from the Affordable Care Act in 2017 — What you need to know

Doctor Tablet Computer Affordable Care ActThe Affordable Care Act is making some changes in 2017 and if you’re providing health insurance via a group plan you need to make sure you’re compliant. Here’s a quick guide to the main changes and what you need to do to ensure you meet all the new guidelines and regulations.

Remember, we’re here to help, so if you have any questions about any of this, please do get in touch. The main changes include:

  • Grandfathered plans — Check your plan is still grandfathered.
  • Deductibles amounts — Changing deductibles for EHB and HSA plans.
  • Employee contributions — Changes to FSB contribution limits from employees.
  • Group plan information — Changes to how information on group benefits and coverage is provided to employees.
  • Reinsurance — No reinsurance fees for self-funded plans in 2017.
  • Large employers — Must offer health plans if you have more than 50 full-time employees.

Grandfathered plans — Check grandfathered status for 2017

You likely have a “grandfathered plan” if the plan was already in existence when the ACA came into effect in March 2010 and it hasn’t had significant changes since then. Grandfathered plans can retain their old benefits, premiums, and other features and fees so long as they don’t have prohibited changes made.

  • If your plan has been grandfathered, check that there aren’t any changes being made that will make it lose the grandfathered status in 2017.
  • If it does lose grandfathered status, you’ll need to ensure it meets all of the regulations and guidelines that the ACA requires.

Essential Health Benefits (EHB) and Health Savings Accounts (HSA)  High Deductibles plans — Amounts changing in 2017

Under the ACA, the Out of Pocket maximum fee for EHBs can’t exceed $7,150 for self-only coverage and $14,300 for family coverage in 2017.

  • Check your plan’s out of pocket maximums to make sure it complies with these guidelines.
  • If you have a Health Savings Account (HSA) plan with high deductibles, make sure those deductibles are below the ACAs allowed limits. In 2017 that’s $6,550 for self-only and $13,100 for families.

Health Flexible Spending Account (FSA) contributions changing in 2017

The amount an employee can contribute, pre-tax, to a health spending account was $2,550 in 2016 and may be increased in 2017. Note that this amount does not apply to employer contributions or to contributions to other benefits such as dependent care assistance.

  • Check to see what the new FSA limit is in 2017, it’s normally announced at the end of the year.
  • If you aren’t able to get that information, use the 2016 limit of $2,550.

Summary of benefits and coverage (SBC) information needs to be updated

The ACA has strict guidelines on how information on benefits and coverage is provided to plan members. In 2017, these guidelines are changing, and a new template will be introduced for SBC information.

  • Use the new SBC template for open-enrollment plans or plans starting on or after April 1 2017.

Reinsurance fees in 2017 — Applies if you are a self-funded plan

From 2014 through 2016, self-funded plans needed to pay fees to a transitional reinsurance program. Starting in 2017, reinsurance fees no longer apply, although your 2016 fees will be due in 2017.

  • Submit the 2016 reinsurance form and make the appropriate payments for the 2016 benefit year.

Applicable Large Employers (ALE) will be subject to penalties if they do not provide appropriate insurance coverage to full-time employees

ALEs must offer affordable health coverage to their full-time employees. They will be penalized if any full-time employee receives a subsidy for health coverage through an Exchange.

  • Calculate the number of Full Time Equivalent (FTE) employees — These are individuals working, on average, more than 30 hours a week or 130 hours a month. If you have more than 50, you are likely an ALE.
  • Ensure that you have proper health care coverage in place for your full time employees in 2017.
  • Report the coverage to your employees and the IRS.

If you’ve got any questions about how this affects you, we’re only a phone call away. We’ve got the experience and expertise to talk you through any changes you need to make.

Jill Goulet
Risk Management Consultant

Sinclair 7-22-15-14

2015 Draft Instructions for 6055 and 6056 Reporting Include Filing Extensions

Sinclair 7-22-15-21The Affordable Care Act (ACA) created new reporting requirements under Internal Revenue Code (Code) Sections 6055 and 6056. Under these new reporting rules, certain employers must provide information to the IRS about the health plan coverage they offer (or do not offer) or provide to their employees. Reporting is first required in 2016, related to coverage offered or provided in 2015.


On Aug. 7, 2015, the Internal Revenue Service (IRS) released the following:

2015 draft Forms 1094-B, 1095-B, 1094-C and 1095-C were previously released on June 16, 2015. Except for a few minor changes and a number of clarifications, the 2015 draft forms and instructions are largely unchanged from the 2014 versions. However, the 2015 draft instructions also include:

  •  A proposed automatic 30-day filing extension, upon request (under certain hardship conditions, reporting entities may apply for an additional 30-day extension); and
  •  A proposed waiver from the requirement to file returns electronically.

These 2015 forms and instructions are draft versions only and should not be filed with the IRS or relied upon for filing. The IRS may make changes prior to releasing final 2015 versions.

Proposed Filing Extensions and Waivers Although the changes made in the 2015 draft instructions were mostly clarifications of existing requirements, they did include new proposed filing extensions and a proposed waiver from the requirement to file electronically.

Filing Extensions Reporting entities can get an automatic 30-day extension of time to file by completing and filing Form 8809, Application for Extension of Time To File Information Returns by the due date of the returns. The form may be submitted on paper or electronically through the FIRE System. No signature or explanation is required for the extension.

Under certain hardship conditions, reporting entities may apply for an additional 30-day extension. See the instructions for Form 8809 for more information.

Furnishing Extensions Reporting entities may also request an extension of time to furnish the statements to recipients by sending a letter to: IRS, Information Returns Branch, Attn: Extension of Time Coordinator, 240 Murall Drive, Mail Stop 4360, Kearneysville, WV 25430.

The letter must include the filer’s name, taxpayer identification number (TIN) and address, the type of return, a statement that the extension request is for providing statements to recipients, a reason for the delay and the signature of the filer or authorized agent. The request must be postmarked by the date on which the statements are due to the recipients.

If a request for an extension is approved, a maximum of 30 extra days will generally be granted to furnish the recipient statements.

Electronic Reporting Waiver To receive a waiver from the requirement to file returns electronically, reporting entities must submit Form 8508, Request for Waiver From Filing Information Returns Electronically, at least 45 days before the due date of the returns.

Without an approved waiver, a reporting entity that is required to file electronically but fails to do so may be subject to a penalty of up to $250 per return, unless it can establish reasonable cause. However, reporting entities can file up to 250 returns on paper; those returns will not be subject to a penalty for failure to file electronically.

2015 Draft Instructions—Additional Clarifications 

The 2015 draft instructions also include the following clarifications:

  • Substitute Forms—Entities using substitute forms instead of the official IRS versions may develop substitute forms themselves or buy them from a private printer. Currently in draft form, Publication 5223, General Rules & Specifications for Substitute ACA Forms 1094-B, 1095-B, 1094-C, and 1095-C and Certain Other Information, explains the requirements for the format and content of substitute statements to recipients. Only forms that conform to the official form and the specifications in Publication 5223 are acceptable for filing with the IRS.
  • Corrected Returns—The 2015 draft instructions include detailed information for correcting returns. The procedure for correcting a return will vary, depending on the form and whether it is filed with the IRS or provided to individuals. The instructions provide examples of errors and step-by-step instructions for filing corrected returns.
  • Expatriate Health Plans—According to the 2015 draft instructions, statements reporting coverage under an expatriate health plan may generally be furnished electronically without affirmative consent, unless the recipient affirmatively refuses consent or requests a paper statement. For more information on expatriate health plans, see Notice 2015-43.
  • Penalties—The 2015 draft instructions include an additional section outlining the penalties for reporting entities that fail to comply with the reporting requirements. For 2015, the IRS will not impose penalties for reporting incorrect or incomplete information if the filer can show that it made good faith efforts to comply with the information reporting requirements. No relief is provided for reporting entities that fail to file on time. For more information on penalty relief, see the Sections 6055 and 6056 FAQs.
  • Multiemployer Interim Rule Relief—For reporting offers of coverage on the Form 1095-C for 2015, an employer relying on the multiemployer arrangement interim guidance should enter Code 1H on line 14 for any month for which the employer enters Code 2E on line 16 (indicating that the employer was required to contribute to a multiemployer plan on behalf of the employee for that month and therefore is eligible for multiemployer interim rule relief). For reporting for 2015, Code 1H may be entered without regard to whether the employee was eligible to enroll in coverage under the multiemployer plan. For 2016 and future years, reporting for offers of coverage made through a multiemployer plan may be reported in a different manner.
  • COBRA Coverage—For purposes of the Form 1095-C, the 2015 draft instructions included additional information for reporting offers of COBRA coverage. In general, an offer of COBRA coverage to a former employee upon termination is reported as an offer of coverage on Line 14 only if the former employee enrolls in the coverage. An offer of COBRA coverage to an active employee (for example, due to a reduction in the employee’s hours) is reported in the same manner and uses the same code as an offer of that type of coverage to any other active employee.
  • Method for Determining Monthly Cost—For purposes of the Form 1095-C, the 2015 draft instructions allow an employer to divide the total employee share of the premium for the plan year by the number of months in the plan year to determine the monthly employee contribution for the plan year. This monthly employee contribution would then be reported for any months of that plan year that fall in the 2015 calendar year.
  • Indexed Affordability Percentage—The 2015 draft instructions note that references to 9.5 percent in the affordability safe harbors and alternative reporting methods may be subject to change if future IRS guidance provides that the percentage is indexed in the same manner as for purposes of applying the affordability thresholds under the premium tax credit. In general, this should not affect reporting for 2015, but taxpayers may visit for any related updates.
  • Minimum Value—The definition of “minimum value” was revised to clarify that the plan must provide substantial coverage of inpatient hospitalization services and physician services. An offer of coverage under a plan that fails to provide substantial coverage of inpatient hospitalization and physician services should be reported on Form 1095-C as not providing minimum value, even if an employer qualifies for the transition rule under Notice 2014-69.
  • Supplemental Coverage—The 2015 draft instructions for Forms 1094-B and 1095-B included information about supplemental coverage. Providers are not required to report the following minimum essential coverage that is supplemental to other minimum essential coverage:
    •  Coverage that supplements a government-sponsored program, such as Medicare or TRICARE supplemental coverage.
    •  Coverage of an individual in more than one plan or program provided by the same plan sponsor (the plan sponsor is required to report only one type of minimum essential coverage).

According to the 2015 draft instructions, coverage isn’t provided by the same plan sponsor if they aren’t reported by the same reporting entity. Thus, an insured group health plan and a self-insured health reimbursement arrangement covering the employees of the same employer aren’t supplemental.

2015 Draft Forms

The 2015 draft forms were largely unchanged from the 2014 versions. One change was addressed in the 2015 draft instructions.

The 2015 draft Form 1095-C includes an additional field, titled “Plan Start Month.” This new field is optional for 2015, but will be required for 2016 and beyond. For 2015, ALEs can choose to:

    •  Add this field and provide plan year information;
    •  Add this field and enter “00”; or
    •  Leave this new field out (thus using the 2014 format).

Additional Resources

The IRS previously released the following final 2014 versions on Feb. 8, 2015:

These forms are not required to be filed for 2014, but reporting entities may voluntarily file them in 2015 for 2014 coverage.

The IRS also released:

Jill Goulet

Benefits Risk Manager – Sinclair Risk & Financial Management

Wellness programs: So much more than losing weight

Dave SinclairMore and more companies are instituting wellness programs in the workplace, and it’s no surprise, given that 92% of owners say they are effective, with real, measurable ROI.

Wellness programs are about more than just passively encouraging employees to exercise and watch what they eat (though research shows that is a very positive objective)!

A robust, well-rounded  wellness program provides a holistic approach to keeping your employees’ minds and bodies strong and in sync.

Starting a wellness program may seem like a big investment in time and resources, but the benefits to your business are significant: reduced workplace injuries, getting injured and ill employees back to work safely and quickly, and creating a more positive working environment, all of which in turn mean greater productivity and a big boost to your bottom line.

Employers committed to workplace wellness need to take an active role in their overall Risk Management. At Sinclair Risk, we have the expertise to help you get started. In fact, iStock_000018191976Smallwellness programs are a particular passion of mine, specifically in demonstrating how Eastern, Complementary and Non-Traditional medicines affect health and safety, work productivity, and ultimately insurance costs.

With ever climbing health insurance premiums, can you afford not to offer a preventative solution? We can work with you to develop a program that makes sense for your business and workforce. Some areas to consider investing in include:

Education — A regular series of lectures from health and wellness experts combined with take home literature and online resources is the foundation of any robust wellness program. Actively educating employees (and yourself!) about health and wellness topics should be a regular part of the workweek.

Training — Providing training that is geared directly toward your workplace environment is vital for workplace safety. Even if you are not a manufacturer, training on “first response” initiatives like CPR, first aid, even the proper use of a fire extinguisher, can help prevent significant injury in an emergency. While safety training should be an integral part of new employee orientation, it’s equally important to provide refresher courses as part of ongoing employee education.

MeditationScientific research shows the benefits of regular meditation, including reduced levels of anxiety and depression, along with better concentration skills and increased levels of happiness. Not surprisingly, all this adds up to a more productive, more congenial workplace. Considered an organized program of meditation that helps employees learn this simple way to feel better.

Return to Work programs — No matter the amount of prevention, some amount of on-the-job injury will occur. That’s where a Return to Work program comes in. Such programs, which can include a variety of features such as new tools for injured employees, modified duties or schedules and/or reassignment, can help reduce time spent out of the workforce. This is good news for the affected employee and the employer.

Ultimately, no matter how great your staff may be, they can’t do the work if they’re not on the job because of illness, injury, or mental fatigue. Investing in a comprehensive workplace wellness program may be the best investment you make this year.

David Sinclair
Sinclair Risk & Financial Management

Massachusetts Earned Sick Time Law effective July 1, 2015

Shannon HudspethOn Nov. 4, 2014, Massachusetts voters approved a ballot measure, known as the “Massachusetts Paid Sick Days Initiative,” to provide earned paid sick leave to employees.The Earned Sick Time Law is effective July 1, 2015, and generally covers all employers in Massachusetts. However, employers must comply with existing collective bargaining agreements or contracts that have more generous leave provisions.

On April 24, 2015, the Massachusetts Attorney General filed draft regulations to implement the Earned Sick Time Law, which clarify practices and policies in the administration and enforcement of the law. The draft regulations are not final, therefore, employers are not required to comply with them.

Also, on May 17, 2015, the Massachusetts Attorney General announced a delay in implementation of the earned sick time requirement, until Jan. 1, 2016, for certain employers who satisfy the requirements of a “safe harbor.”

Covered employers

In general, all employers in Massachusetts are required to comply with the Earned Sick Time Law. However, the paid leave requirement only applies to employers with 11 or more employees, as follows:

  • Employers with 11 or more employees must allow all employees to earn and use paid sick time.
  • Employers with fewer than 11 employees must allow all employees to earn and use unpaid sick time.

Eligible employees

All employees—including part-time, temporary and seasonal employees—working in Massachusetts are eligible to accrue earned sick time. Whether an employee’s accrued earned sick time is paid depends on the size of his or her employer.

Employers may restrict the use of earned sick time for the first 90 days of employment.

Accrual of earned sick time

The Earned Sick Time Law requires that employees earn a minimum of one hour of sick time for every 30 hours worked, starting July 1, 2015, up to a maximum of 40 hours per calendar year.

Employees must be permitted to carry over up to 40 hours of earned but unused sick time into the next calendar year. However, the law does not require employers to allow employees to use more than 40 hours of earned sick time in a calendar year.

Reasons for leave

An employee may use earned and accrued sick time, whether paid or unpaid, to:

  • Care for a physical or mental illness, injury or medical condition affecting the employee or his or her child, spouse, parent or parent-in-law;
  • Attend routine medical appointments of the employee or his or her child, spouse, parent or parent-in-law; or

Address the effects of domestic violence on the employee or his or her dependent child.

Notice and certification requirements

When possible, and when the need for leave is foreseeable, the law requires employees to make a good faith effort to provide advance notice of leave to their employers.

In addition, employers may require medical documentation or certification for the need to use earned sick time if the employee is absent for more than 24 consecutive work hours. However, an employer may not delay or deny sick time if this certification is not received.

Employee protections

An employer may not interfere with an employees’ right to use earned sick time and may not retaliate against any employees who request to use earned sick time.

Draft Regulations

On April 24, 2015, the Massachusetts Attorney General filed draft regulations to implement the Earned Sick Time Law. These draft regulations clarify practices and policies in the administration and enforcement of the Earned Sick Time Law including, but not limited to, the following:

  • Requirements that an employer’s paid time off, vacation or other PTO policy must meet in order to be considered an allowable substitution for an earned sick time program;
  • How employers are to address the “transition year” of July 1, 2015, until the beginning of the next calendar year for employee accrual and use purposes;
  • Employer documentation and recordkeeping requirements; and
  • How the Earned Sick Time Law affects attendance policies that reward employees for good attendance.

The draft regulations are not final. Therefore, at this time, employers are not required to comply with them. There will be various public hearings on the draft regulations, including a public comment period, which ends on June 10, 2015. The draft regulations, as well as information on public hearings and comment submissions, are available on the Attorney General’s website.

Delayed Implementation safe harbor

Employers who satisfy the requirements of a safe harbor may delay the implementation of earned sick time until Jan. 1, 2016, according to the Massachusetts Attorney General.

To qualify for this safe harbor, all of the following requirements must be met:

  • The employer must have had a paid time off policy in place as of May 1, 2015;
  • The employer’s paid time off policy must have provided employees with the right to use at least 30 hours of paid time off during the 2015 calendar year; and
  • Any paid time off, including sick time, used by an employee from July 1, 2015, to Dec. 31, 2015, must be job-protected leave subject to the law’s non-retaliation and non-interference provisions.

On or before Jan. 1, 2016, all employers operating under this safe harbor must adjust their paid time off policy to conform to the requirements of the Earned Sick Time Law.

More information on the Massachusetts Earned Sick Time Law is available on the Massachusetts Attorney General’s website.

Shannon Hudspeth, SPHR



Connecticut Employee Wellness Plans: National Employee Wellness Month

Connecticut Employee Wellness Plans National Employee Wellness MonthConnecticut Employee Wellness Plans: National Employee Wellness Month

June marks the National Employee Wellness Month. On its fifth anniversary, National Employee Wellness month aims to help business leaders learn how companies are engaging their employees to pursue healthy lifestyles. The goal of the initiative is to showcase how prevention strategies in a supportive social community such as the workplace can lead to multiple benefits including improved employee health and productivity, lower healthcare costs and an overall healthy workplace culture.

The workplace places a significant role in individuals’ daily lives, and employee benefits and wellness programs promoting a healthy lifestyle can have a considerable impact. In one survey, 87 percent of employees said they considered health and wellness offerings when choosing an employer. And 70 percent of employees say that wellness programs positively influence the culture at work.

The changes don’t have to be large scale. In honor of National Wellness Month, here are some tips on how employers can encourage a healthy workplace environment.

  • Cater meetings or events with healthy foods.
  • Organize a team for a local softball or rec sports league.
  • Coordinate workplace walking groups before, during lunch breaks, or after work; start lunch time boot camps with calisthenics.
  • Provide healthy eating resources to employees- you can look to various health organizations such as National Employee Wellness Month for a list of various resources.
  • Organize employee potlucks where everyone contributes a healthy recipe.
  • Post hand-washing reminders in the bathroom.
  • Provide healthy snacks for employees to munch on during office hours.
  • Implement an employee wellness plan at work.

Sinclair Risk & Financial Management provides the expertise, experience and suite of products and solutions to help clients protect and build personal wealth. Wallingford, CT Financial planning is a natural extension of our Connecticut employee benefits solutions. It takes a comprehensive, ongoing approach that keeps up to date with changes in your life and business. Contact us today for more information. (877) 602-2305.

Wallingford Group Benefits: Small Business Healthcare Exchange Delayed

Wallingford Group Benefits Small Business Healthcare Exchange DelayedWallingford Group Benefits: Small Business Healthcare Exchange Delayed

Small business owners will have to wait at least until 2015 before they can offer a choice of health care plans to their employees.

In the latest news on the implementation of the Affordable Care Act, the administration announced they would be unable to meet the deadlines outline in the ACA.

The ACA calls for a new insurance marketplace specifically for small businesses to be set up next year. The goal was to provide workers with a choice of health plans. However, instead they will only have one option- whichever one their employer chooses. This option is already available to many big businesses.

The administration cited “operational challenges” as a reason for the delay. There has also been concern from companies, health plans and brokers wouldn’t be able to adjust to the new marketplace in time.

These changes will only affect the 33 states where the federal government will be running insurance markets. They will delay the deadline requirement for other states as well.

The goal of the small business exchange is for business owners to be able to offer employees the choice of qualified health plans from several insurers, as many larger companies can. Having them all in the insurance exchange will also consolidate billing for business owners.

Businesses with up to 100 employees will be able to buy insurance in the exchanges, but in 2014-15, states can limit participation to businesses with 50 or fewer employees.

Sinclair Risk & Financial Management works with companies of all sizes to design and implement Wallingford CT Group Benefits Medical options that rethink the traditional way of offering benefits and meet the financial needs of employers while also addressing the choices and flexibility employees want. Contact us today for more information (877) 602-2305.

Wallingford Health Insurance: Business Owners Weighing Both Sides

Wallingford Health Insurance Business Owners Weighing Both SidesWallingford Health Insurance: Business Owners Weighing Both Sides

There is a lot of uncertainty about how the healthcare reforms will affect business owners as the changes begin to roll out, especially in terms of cost. Now required to provide health insurance for all employees, business owners are debating forgoing the health insurance and paying the fee.

Under the Affordable Care Act, employers with 50 or more full-time workers will be required to provide coverage for employees who work an average of 30 or more hours a week in a given month. If they don’t comply, business owners will pay a $2,000 dollar penalty for every full-time worker over a 30-employee threshold.

The requirement has many business owners, especially those in the retail and hospitality sector, which employ large numbers of full-time workers but typically don’t provide health insurance, worried they will be unable to keep up with healthcare costs. As an alternative, some business owners are considering forgoing their coverage entirely and opt to pay the penalty instead, according to the Wall Street Journal.

However those numbers remain small. One study of 400 employers with 50 or more workers found 71% planned to continue offering health insurance while only 3% said they planned to pay the penalty. In addition, there is a drawback to the pay-the-penalty strategy. Health insurance is deductible as a business expense, but penalties aren’t.

Businesses are in a difficult transition, and there are many unknown factors and effects that will emerge and the new healthcare reforms roll out. Employers are looking for health insurance alternatives to help with skyrocketing medical costs and regulatory changes that can impact their expenditures.

Sinclair Risk & Financial Management works with companies of all sizes to design and implement Group Medical options that rethink the traditional way of offering benefits and meet the financial needs of employers while also addressing the choices and flexibility employees want. Contact us today for more information about our Wallingford and New Haven County Group benefits programs(877) 602-2305