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ACA Affordability to Extend Beyond Employee-only Coverage

Jeff Griffin

Since its inception, the Affordable Care Act (“ACA”) has measured “affordability” based solely on the cost of employee-only coverage.  This so-called “family glitch” has meant that spouses and dependent children of employees who are offered affordable, minimum value coverage have not been eligible for federal tax credits (Premium Tax Credits; “PTCs”) to purchase coverage through the marketplace.  

As a result, even though such family members might not receive a penny of employer-subsidized health coverage, an employer’s satisfying mandate duties to the employee has always been “imputed” to children and spouses, thereby effectively blocking those family members from obtaining any federal money.

Recently the Internal Revenue Service (“IRS”) announced proposed regulations that would change this. This IRS change solely alters family access to federal marketplace coverage subsidy funding but does NOT expand the employer mandate to include family coverage.

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Topics: ACA, PPACA

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Sweeping Changes Coming to Employer-Funded 401(k) Plans

Jeff Griffin

Historically speaking, retirees have typically relied on three primary tools to help them prepare for retirement: pension plans, Social Security, and defined contribution plans, like 401(k) plans.

That’s no longer the case. Pension plans are virtually non-existent, falling from nearly half of private sector participation in the mid-1980s to less than 15% today.   

As for Social Security, while it still provides the vast majority (90%) of income for nearly a quarter of retirees, the trust fund is facing a historic deficit, and without intervention, it will be depleted by the mid-2030s. 


Faced with these obstacles, lawmakers are turning their attention to 401(k) plans, which are available to 68% of private industry workers, yet only 50% utilize them.

This is welcome news. By the end of this decade, the percentage of the U.S. population 65 or older will increase 40%, from 15% to 21%, according to the Census Bureau. Most concerning - nearly two-thirds of adults think they aren’t saving enough for retirement. 

A new bill, expected to reach President Joe Biden's desk by the end of the year, could usher in wide-sweeping changes to 401(k) plans. It could include auto-enrolling workers, escalating contributions over time, increasing contribution limits, integrating student loan repayments, delaying mandatory withdrawals, allowing part-time employee participation, and lowing costs for small businesses. 

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Topics: Retirement Planning

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ICHRAs: A Potential Health Coverage Alternative for Employers

Jeff Griffin

Individual Coverage Health Reimbursement Arrangements (ICHRAs) are a new type of health reimbursement arrangement in which employers of any size can reimburse employees for some or all of the premiums that the employees pay for health insurance.

Employers can reimburse employees tax-free for individual health insurance, including coverage purchased on federal or state-sponsored health insurance exchanges, the individual markets, or Medicare.

And under federal rule changes in 2019, ICHRAs can be structured to fulfill the employer mandate under the ACA that requires most organizations to offer “affordable coverage" for employees.

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Topics: Cost Containment, ACA, Medical Plan

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The Omicron BA.2 Subvariant – What Employees Are Asking About COVID-19 At-Home Testing & Mixing Booster Shots

Jeff Griffin

Several high-profile people have tested positive for COVID-19 these past few weeks, including Sarah Jessica Parker, Miley Cyrus, Daniel Craig, and nearly 75 of Washington's elites such as House Speaker Nancy Pelosi and Attorney General Merrick Garland, just to name a few.

Accordingly, interest has grown in a fourth vaccine dose, approved recently by the FDA, for Pfizer and Moderna, for people age 50 or older (as well as a few other groups with weakened immune systems).

With major cities in Europe and China, as well as some parts of the U.S. seeing an uptick in cases driven by the BA.2 subvariant, the CDC quickly backed the FDA's decision, though it's worth noting that both agencies made their decisions without consulting their committees of independent vaccine experts. While this has been done before, this action continues to come under intense scrutiny.

With renewed worries about another wave of coronavirus infections comes three questions employees and employers have on their minds:

1) Are today's at-home tests capable of detecting the Omicron BA.2 subvariant? 

2) Are health plans still required to cover at-home rapid tests?

3) What's the latest guidance on mixing booster shots?

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Topics: Preventative Care, COVID-19

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How to Update HR Technology Systems When the Pace of Change Is Overwhelming

Jeff Griffin

Technology like artificial intelligence, machine learning, and predictive analytics are transforming Human Resources information systems. The change is happening so rapidly that even those who updated their human capital management (HCM) systems as recently as five years ago likely aren’t up-to-speed on the changes.

The pace of change is reflected in the growth of human resources technology: In 2020, the global human resource management market comprised sales of $17.6 billion, with estimated annual growth of 12.2% through 2028.

Many HR managers and executives simply don’t know what’s possible, making it difficult to upgrade even antiquated systems. The future for HCM is bright, but not all HR departments can yet see the possibilities in the new systems.

Our HR Technology Specialty Practice experts are well-versed in helping employers navigate this ever-evolving landscape of HCM technology. Here are a few steps to follow as you begin your journey towards upgrading your HR tech.

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Topics: Automation, Employee Productivity, HR Technology

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Addressing Employee Financial Wellness in an Era of Extreme Financial Stress

Jeff Griffin

When 56% of student loan borrowers say they’d take a punch in the face from heavyweight boxing legend Mike Tyson and 40% would take one year off their life expectancy if it meant they’d be relieved of student debt, it probably means the public is under financial stress.

And that was before the coronavirus pandemic further complicated finances. Financial stress seems to be endemic: Three-quarters of American workers say they feel financial anxiety every day. The causes for this are numerous and varied, from insufficient savings (80%) and retirement funds (73%) to ballooning credit card balances (19%).

Financial anxiety doesn’t exist in a vacuum. There’s a tight link between financial, emotional, and physical health, and when an employee’s financial anxiety becomes overwhelming, it can affect the body and mind.

What’s more, that state of financial distress results in rising rates of presenteeism, absenteeism, and workplace accidents that can result when workers are distracted by financial worries. Consider that 43% of employees spend time working on their personal finances while at work.

As a result, many employers realize that a myopic focus on core benefits like health, dental, and vision shortchanges employees. Finding ways to integrate financial wellness into a holistic wellness strategy will be a competitive advantage, especially as many workers are emerging from the pandemic feeling financially scarred from the experience.

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Topics: workplace wellness, Employee Productivity, presenteeism, absence management

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3 Ways to Strengthen Cost Management for Pharmaceutical Benefits

Jeff Griffin

When considering prescription drug cost savings, plan sponsors know where to look: the cost of specialty drugs.

Specialty drug treatments accounted for approximately 52% of pharmacy spending in 2020, and when 2021 is fully accounted for, that number is expected to increase. Plan sponsors can expect specialty drug spending to hit 55% or more of total drug costs in 2022.

And it’s no surprise that specialty drugs are eating up a huge amount of total drug spending — whether it’s an oncology drug, a drug to treat a rare condition, or a biologic with multiple indications, the annual cost of a single specialty treatment can easily run into five, six or even seven figures.

Because of its increased percentage of total drug spending, specialty drug costs are proving a major headache for plan sponsors. They need to find ways to control spending on these treatments, lest the cost of the drug benefit become prohibitive.

Here are three ways to manage the cost of pharmaceutical benefits.

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Topics: Cost Containment, Prescription Drugs

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Best Of 2021: Employee Benefits Blog Posts and Downloads

David Rook

Thousands of companies turned to JP Griffin Group for guidance on employee benefits topics in 2021. With nearly a half-million blog post views and tens of thousands of content downloads, here is some of our most popular content for the calendar year.


Does Healthcare Consumerism Even Have A Chance?

It’s difficult to become more informed consumers of healthcare when large swaths of that very system seem to be working against us at every turn. Do consumers even have a chance?

2022 IRS Contribution Limits for HSA, HDHP, FSA, 401(k)

A consolidated list of 2022 IRS contribution limits for tax-advantaged employee benefits accounts such as HSAs, FSAs, 401(k)s, QSEHRA, transportation, and adoption benefits.

What's the Difference Between Telemedicine, Telehealth, and Telecare?

It's important to understand the differences between telemedicine, telehealth, telecare, virtual medicine, virtual health, and virtual care.

Vendor Contracts – Beware of These Five Pitfalls in Employee Benefits Agreements

Employers should carefully review the provisions of their employee benefits vendor contracts. Here's a list of common provisions requiring special attention.

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Topics: Employee Communications

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Budgeting for Benefits: Sage Advice for Cost-Conscious Employees

David Rook

Editor's note: We'd like to thank Ann Lloyd of StudentSavingsGuide.com for collaborating with us on this week's blog post.

Employee benefit offerings can be powerful motivational tools. They can help steer workers to new opportunities or drive loyalty to current organizations.  This has never been more true than in today’s hypercompetitive job market.

But as we discussed recently, offering robust and generous benefit programs isn’t enough. Employers must communicate these programs clearly and concisely since research shows that confusing and complex benefit programs can be stress-inducing - and a real turn-off to current employees and future talent prospects.

One of the main issues weighing heavily on workers, particularly those who are younger and/or in low-wage jobs, is that of money. Benefits, after all, can be quite expensive, depending on how generous or stingy an employer chooses to be.

Here are some best practices for employers to use when coaching more cost-conscious employees through the benefits enrollment process.

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Topics: Employee Communications

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2022 IRS Contribution Limits For Tax-Advantaged Employee Benefit Programs (Consolidated)

Jeff Griffin

The IRS has finally announced adjustments to 2022 contribution limits on various tax-advantaged health and dependent care spending accounts, retirement plans, and other employee benefits such as adoption assistance and transportation benefits. Many of these contribution limits, though not all, are indexed to cost-of-living adjustments.

Together, these combined announcements by the IRS detail 2022 adjusted limits to the amounts employees can tuck away pretax into Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), transportation benefits, and retirement plans such as 401(k)s.

While IRS limits for HSAs and HDHPs are required, by law, to be announced by June 1st, limits for these other pretax savings vehicles always seem to come so late in the year that many employers have already completed their employee benefits open enrollments.

Employers who have already completed open enrollment for 2022 have two choices when it comes to communicating these updates; 1) they can do nothing, since there isn't an obligation to make the maximum election amounts available to employees, or 2) they can reopen the enrollment process and let employees who want to increase their elections do so before December 31st, for calendar year plans.

What follows is a summary of the new IRS limits;

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Topics: Compliance, Employee Communications, HSAs, Retirement Planning, HDHPs, FSAs

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