Category: Compliance Corner

What Does the PACE Act Mean to Me?

Oct
26
2015
We’ve become so accustomed to delays or changes surrounding implementation of the Affordable Care Act (ACA), it would not surprise us if the passage of the PACE Act went unnoticed. Of course you received several emails telling you that President Obama signed the Protecting Affordable Coverage for Employees Act (PACE), but what does it really mean to you? If you are an employer with approximately 50 to 99 full-time employees (including full-time equivalents), the PACE Act is probably good news for you. Prior to the ACA, most states defined small employers as those with less than 50 employees. In the group health insurance market, small employers were subject to different rules, including how their policies were underwritten. The ACA intended to redefine “small employer” to mean all employers with less than 100 employees. Beginning January 2016, employers with 50 to 100 employees would for the first time be considered a “small employer” and subject to the ACA’s rules governing small employers. Application of the ACA’s rules governing small employers to employers with 50 to 100 employees would have imposed strict community rating rules that would likely result in substantial premium increases and would require coverage for “essential health benefits” which may also contribute to higher premiums. Because the PACE Act was passed, employers with 50 to 100 employees can breathe a sigh of relief. What remains the same: Employers with less than 50

Wellness Plans: Look Both Ways Before Crossing the Road

Dec
11
2014
Renee Kuhs, Compliance Attorney, Vizance, Inc. Look both ways before crossing the road. Does this advice sound familiar? Is it something your mother said to you every time you left the house? Is it advice you have passed along to your children? These words of caution are well suited for employers that have or are seeking to implement a Wellness Plan. The EEOC recently filed lawsuits against three employers alleging their Wellness Plans violate the Americans with Disabilities Act. Two of these employers are located in Wisconsin; one employer is in Minnesota. Employers are often surprised to learn that the Wellness Plan they have had in place for years violates federal law. Over the last seven years, I’ve worked with numerous employers to correct compliance problems with their Wellness Plan. Employers often rely upon an insurance carrier, insurance broker, or wellness consultant to help them implement their Wellness Plan. While these parties all bring expertise to the process, one important component is consistently missing – compliance with laws governing the employer. The three lawsuits that have been brought by the EEOC were filed against the employer. Neither the insurance broker nor the wellness consultant has been made a party to the lawsuits. How will looking both ways before an employer crosses the road avoid litigation? Wellness Plans have typically been developed by focusing solely on the rules contained within the Health Insurance Portabilit

Same-Sex Marriages & Domestic Partnerships in Wisconsin

Nov
24
2014
By Renee Kuhs, Compliance Attorney, Vizance, Inc. Effective October 6, 2014, Wisconsin recognizes same-sex marriages. Wisconsin residents in a same-sex relationship may file for a marriage license in Wisconsin. Same-sex marriages that took place in another state will now also be recognized in Wisconsin. Employers should consider how this change will impact their employment practices and health insurance plans. FMLA In 2009, Wisconsin’s FMLA was modified to provide rights to individuals that were in a domestic partnership. In light of the recognition of same-sex marriages in Wisconsin, individuals in a same-sex marriage will also be entitled to the rights provided to legal spouses under Wisconsin’s FMLA. Rights available under federal FMLA have been afforded to same-sex spouses if the marriage was recognized under the laws of the state where the individual resides. With the change in Wisconsin’s law on same-sex marriages, same-sex spouses are also entitled to protection under the federal FMLA effective immediately. Health Insurance Coverage Employers that offer a fully-insured health plan to its employees will be required to comply with Wisconsin insurance laws. The Office of the Commissioner of Insurance regulates fully-insured health plans in Wisconsin. To date they have not released official guidance in response to this change in law. However, the Affordable Care Act (ACA) prohibits insurance carriers from discriminating based upon sexual orientation. Beg