Tag Archives: Small Business

Health Care Law Makes Tax Season Tougher for Small Companies

As more requirements of the health care law take effect, income tax filing season becomes more complex for small businesses.

Companies required to offer health insurance have new forms to complete providing details of their coverage. Owners whose payrolls have hovered around the threshold where insurance is mandatory need to be sure their coverage — if they offered it last year — was sufficient to avoid penalties.

Even the most tax-savvy owners may find that do-it-yourself doesn’t work when it comes to fulfilling the law’s requirements. Many don’t know about the intricacies of the new health care regulations associated with the law that affect employers, says Lydia Glatz, an accountant with the firm MBAF in Fort Lauderdale, Florida.

“Most small businesses and mom-and-pop operations,” Glatz says. “They’re more involved in running their day-to-day business.”

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Health Care Law Forces Businesses to Consider Growth’s Costs

When LaRonda Hunter opened a Fantastic Sams hair salon 10 years ago in Saginaw, Tex., a suburb of Fort Worth, she envisioned it as the first of what would eventually be a small regional collection of salons. As her sales grew, so did her business, which now encompasses four locations — but her plans for a fifth salon are frozen, perhaps permanently.

Starting in January, the Affordable Care Act requires businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. Ms. Hunter, who has 45 employees, is determined not to cross that threshold. Paying for health insurance would wipe out her company’s profit and the five-figure salary she pays herself from it, she said.

The margins are not big enough within our industry to support it,” she said. “It’s not that I don’t want to — I love my employees, and I want to do everything I can for them — but the numbers just don’t work.”

The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it.

Without the mandate, the law’s creators feared, companies would be tempted to cancel their insurance benefits and encourage employees to move to the online marketplace exchanges created by the law, where many low- and middle-income workers qualify for government subsidies. Those who are offered insurance through their jobs are ineligible to collect subsidies if they instead choose to buy coverage through the exchanges.

The rule took effect this year for businesses with 100 or more workers, but companies with 50 to 99 employees got an extra year to comply. Those with fewer than 50 workers are exempt.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Employer-covered insurance doesn’t drop despite ACA, report finds

The percentage of workers covered by employer-sponsored health insurance has held steady, despite arguments that the Affordable Care Act would spur a decline. Between June 2013 and March 2015 just over 70% of U.S. workers were covered by a plan provided by their employer, according to a study released Wednesday by the Urban Institute Health Policy Center. To that end, employers regardless of company size continued to offer insurance coverage, the study found. The number of small-firm employers that offered insurance grew to 61.3% in March 2015, up from 60.6% in June 2013. To read more, click here:

Jeffrey R. Ungvary

How Do You Get Patients to Engage?

With more quality and pricing data available now than ever before, insurers and employers are trying to figure out how to steer patients toward high-performing, low-cost doctors. Companies such as the Leapfrog Group and nonprofits like FAIR Health are creating tools that make medical data easier to access, but turning patients into rational consumers is still a challenge. More than half of hospital patients in the U.S. enter through the emergency room, according to a 2013 report by the RAND Corp. And some choice tools are less relevant for consumers in narrow provider networks.

The key to leveraging data is patient engagement, said Mario Schlosser, CEO of Oscar Health Insurance, at a Manhattan Institute conference Friday. For instance, Oscar users can earn money back by using the company’s free fitness tracker, but to use it, they have to sync it with the Oscar app. “Once they click on the app, we can get them to use it for other things,” said Mr. Schlosser.

In addition to offering patients a way to search for doctors, that includes collecting data and anticipating costs by asking about symptoms.

Bloomfield, Conn.-based Cigna has focused on ease of use in its Web portal and mobile application, said Michael Sturmer, the company’s senior director of consumer health engagement.

“If I can give them choice, but make it simplified choice, I can influence their decisions on providers,” he said at an event in Manhattan last month hosted by the Northeast Business Group on Health.

Still, only 10% to 20% of patients use those types of tools, he said.

According to Mr. Schlosser, sometimes it’s best to eliminate patient choice altogether by simply recommending the best doctor available in a customer’s care network.

Will this hands-on approach by insurers lead to a hands-off approach by employers? The rise of ACA exchanges and consumer-centric insurance companies like Oscar are driving some businesses to distance themselves from employee health care, said Laurel Pickering, president and CEO of the Northeast Business Group on Health.

“They want their employees to be better consumers,” Ms. Pickering said. “That’s why some are putting in private exchanges.”

But Ms. Pickering said that moving away from the employer-as-middleman will be a long process. Enrollment in private health exchanges grew to more than 3 million in 2014, according to a report by Accenture, but it is still relatively uncommon, Ms. Pickering said.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

OSHA Releases New ‘It’s The Law’ Poster

The Occupational Safety and Health Administration (OSHA) has released a new version of its “Job Safety and Health – It’s The Law!” poster.

Background
Under the Occupational Safety and Health Act (OSH Act), employers have certain responsibilities, including the obligation to:

  • Provide their employees with a safe workplace;
  • Follow all relevant safety and health standards;
  • Find and correct safety and health problems in the workplace; and
  • Inform employees about workplace hazards.

Content of New Poster
The newly designed poster informs employers of their legal obligation to provide a safe workplace. It also informs workers of their right to request an OSHA inspection of their workplaces, receive information and training on job hazards, report a work-related injury or illness, and raise safety and health concerns with their employer or OSHA without being retaliated against.

Additionally, the poster has been updated to include the new reporting obligations for employers, who must now report every fatality and every hospitalization, amputation and loss of an eye. It also informs employers of their responsibilities to train all workers in a language and vocabulary they can understand, comply with OSHA standards, and post citations at or near the place of an alleged violation.

Posting and Size Requirements
Employers must display the poster in a conspicuous place where workers can see it. Reproductions or facsimiles of the poster must be at least 8 1/2 by 14 inches with 10 point type. According to OSHA,previous versions of the poster do not need to be replaced.

Note: Employers in states operating OSHA-approved state plans should obtain and post the state’s equivalent poster.

The poster is available by clicking here. Multiple languages and resolutions are available for download.

To learn about other federal notices required to be displayed in the workplace, please visit our section on Federal Poster Requirements.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

On Demand Doctor Apps are Here

New smartphone apps can deliver doctors to your doorstep.

Heal is a smartphone app similar to the on-demand car service Uber, but instead of a car, a doctor shows up at your door. Users download the app and then type in a few details such as address and the reason for the visit. After adding a credit card and a request for a family doctor or a pediatrician, the physician arrives in 20 to 60 minutes for a flat fee of $99. Heal began in Los Angeles in February, recently expanded to San Francisco and is set to roll out in another 15 major cities this year. Heal doctors are on call from 8 a.m. to 8 p.m., seven days a week, said Dr. Renee Dua, a founder and the chief medical officer of Heal.

Heal doctors arrive with a medical assistant and a kit stocked with the latest high-tech health gadgets, including tools needed to take your vitals or shoot high-definition video of your eardrum. Heal has a roster of doctors who have affiliations with respected hospitals and programs such as the University of California, Los Angeles; Columbia; and Stanford.

“We’re bringing back old-school techniques with new-school technology,” Dr. Dua said.

Obviously, Heal doctors can offer only limited services on a house call. Among other things, they can diagnose and treat moderate ailments like bronchitis, give flu shots, stitch up a nasty cut or write a prescription (they will even pick the prescription up for an extra $19). But you will have to file the insurance paperwork.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Data Released to The Public on Medicare Prescription Spending

The heartburn drug Nexium — whose advertisements have long been ubiquitous on television — was prescribed to 1.5 million Medicare patients in 2013, for a total cost of more than $2.5 billion, the largest amount spent on any drug prescribed through the government program, according to data released by Medicare officials on Thursday.

The data was the most detailed breakdown ever provided by government officials about the prescription claims of Medicare beneficiaries. It included information about 36 million patients, one million prescribers and $103 billion in spending on drugs under the program’s Part D in the year 2013, the most recent year available. The data did not take into account rebates that the drug manufacturers pay to the insurers that operate the Medicare beneficiaries’ drug plans.

Although the government has previously released similar data to outside entities — including ProPublica, the nonprofit news group — officials said they decided to make the information available on a public website to encourage experts to weigh in, potentially leading to new solutions for policy challenges, like how to contain costs.

“We know that there are many, many smart minds in this country,” Sean Cavanaugh, a deputy administrator at the Centers for Medicare and Medicaid Services, said in a conference call with reporters on Thursday. “We are excited to unleash those minds and see what they can find in our data.”

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Senate Approves Sweeping Changes to Medicare

The Senate on Tuesday overwhelmingly approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade.

The 92-to-8 vote in the Senate, following passage in the House last month by a vote of 392 to 37, was a major success for Republicans, who devised a solution to a complex policy problem that had frustrated lawmakers of both parties. Mr. Obama has endorsed the bill, saying it “could help slow health care cost growth.”

The bill, drafted in the House in negotiations between Speaker John A. Boehner and Representative Nancy Pelosi, the Democratic leader, also extends the Children’s Health Insurance Program for two years, through 2017.

Without action by Congress, doctors would have faced a 21 percent cut in Medicare fees on Wednesday or Thursday. Senate leaders cleared the way for final passage by allowing votes on several amendments sought by liberal Democrats and conservative Republicans.

Medicare spent $70 billion last year under the fee schedule used to pay doctors and some other health care professionals. That accounts for about 12 percent of all Medicare spending. Ninety-eight percent of people enrolled in the traditional fee-for-service Medicare program receive at least one physician service during the year.

The legislation moves Medicare in a direction espoused by Mr. Obama and many health policy experts, toward payment based on the quality and value of care, rather than just the volume of services. Organized medicine now accepts that change in principle, and the American Medical Association lobbied strongly for the bill, demanding that Congress “fix Medicare now.”

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

The War On Work and Sleep

There are a lot of advantages to earning more money, but getting a good night’s sleep may not be one of them.

It turns out that, in general, the more money people make, the less they sleep. That’s been true for decades in the United States, and in other countries as well. On average, adults earning the highest incomes — around $98,000 for a family of four — sleep 40 minutes less than people in the lowest-income families. And among short sleepers — those who are in the bottom 10 percent of nightly rest — high-income people are overrepresented, according to the government survey that sleep researchers trust most.

Sleeping too little is really bad for your health. Researchers have demonstrated that, for most people, sleeping less than six hours a night results in cognitive impairment. Poor sleep is also associated with a number of other health problems, and an increased risk of dying in a car accident.

In general, the factor that seems the most closely tied with how much sleep people get is how much they work. More hours of work tend to crowd out sleep. People who work two jobs sleep the least of anyone, according to a recent study, and are most likely to be in the bottom 10 percent of sleepers, sometimes called “short sleepers.”

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

FMLA Definition of ‘Spouse’ Under Final Rule

Effective March 27, 2015, a final rule from the U.S. Department of Labor will extend the protections of the federal Family and Medical Leave Act (FMLA) to all eligible employees in legal same-sex marriages, regardless of where they live.

Background
Under the FMLA, an eligible employee of a covered employer (50 or more employees in at least 20 workweeks in the current or preceding calendar year) is entitled to take unpaid, job-protected leave for specified family and medical reasons, including to care for the employee’s spouse who has a serious health condition.

The U.S. Supreme Court’s decision in United States v. Windsor struck down the federal Defense of Marriage Act provision that interpreted “marriage” and “spouse” to be limited to opposite-sex marriage for purposes of federal law. In response, the DOL revised its agency guidance, effective as of June 26, 2013, to clarify the definition of “spouse,” for purposes of the FMLA, to mean a husband or wife as defined or recognized under state law for purposes of marriage in the state where the employee resides, including “common law” marriage and same-sex marriage.

Final Rule
Consistent with previously issued proposed rules, the final rule includes the following major features:

  • The FMLA regulatory definition of “spouse” is based on the law of the place where the marriage was entered into, sometimes referred to as the “place of celebration” (currently, the regulatory definition of “spouse” only applies to same-sex spouses who reside in a state that recognizes same-sex marriage, referred to as the “state of residence” rule).
  • The final rule’s definition of “spouse” expressly includes individuals in lawfully recognized same-sex and common law marriages, as well as same-sex marriages entered into abroad that could have been entered into in at least one state.

This definitional change means that eligible employees, regardless of where they live, will be able to:

  • Take FMLA leave to care for their lawfully married same-sex spouse with a serious health condition;
  • Take qualifying exigency leave due to their lawfully married same-sex spouse’s covered military service;
  • Take military caregiver leave for their lawfully married same-sex spouse; or
  • Take FMLA leave to care for their stepchild (child of the employee’s same-sex spouse) or stepparent who is a same-sex spouse of the employee’s parent, even if certain in loco parent is requirements are not met.

More information is available on the DOL’s FMLA Final Rule Website, which includes links to the DOL’s fact sheet and frequently asked questions.

For additional information about the eligibility requirements and qualifying reasons for FMLA leave, visit our section on the Family and Medical Leave Act.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary