Yearly Archives: 2014

  • They’re in control…but not quite, or at least not enough. Is that a good thing?

    December 31, 2014

    With some upset victories, California Democrats knew what it felt like in Congress as they lost their super majorities in both California houses.  When a series of special elections finishes next year they will be one vote short in the Senate and two in the Assembly.

  • OSHA’s New Reporting and Recordkeeping Rule Goes into Effect on January 1, 2015 | California Employee Benefits

    December 29, 2014

    Tags: , ,

    peopleOn September 11, 2014, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) announced a final rule which updates the reporting and record-keeping requirements for injuries and illnesses, found at 29 C.F.R. 1904. The rule goes into effect on January 1, 2015.

    Changes to record-keeping requirements

    Under OSHA’s record-keeping regulation, certain covered employers are required to prepare and maintain records of serious occupational injuries and illnesses using the OSHA 300 Log. However, there are two classes of employers that are partially exempt from routinely keeping injury and illness records:

    • Employers with 10 or fewer employees at all times during the previous calendar year; and
    • Establishments in certain low-hazard industries.

    The new rule maintains the exemption for employers with fewer than 10 employees. However, the new rule has an updated list of industries that will be partially exempt from keeping OSHA records. The previous list of partially exempt industries was based on the old Standard Industrial Classification (SIC) system and injury and illness data from the Bureau of Labor Statistics (BLS) from 1996, 1997, and 1998. The new list of partially exempt industries in the updated rule is based on the North American Industry Classification System (NAICS) and injury and illness data from the Bureau of Labor Statistics (BLS) from 2007, 2008, and 2009. As a result, many employers who were once exempted from OSHA’s recordkeeping requirements are now required to keep records. A list of newly covered industries can be found at

    Changes to the reporting requirements

    In addition to revising the record-keeping requirements, the new rule expands the list of severe injuries and illnesses that employers must report to OSHA. Under the previous rule, employers were required to report the following events to OSHA:

    • All work-related fatalities.
    • All work-related hospitalizations of three or more employees.

    Under the new rule, employers must report the following events to OSHA:

    • All work-related fatalities.
    • All work-related in-patient hospitalizations of one or more employees.
    • All work-related amputations.
    • All work-related losses of an eye.

    For any fatality that occurs within 30 days of a work-related incident, employers must report the event within eight hours of finding out about it.

    For any in-patient hospitalization, amputation, or eye loss that occurs within 24 hours of a work-related incident, employers must report the event within 24 hours of learning about it.

    Employers do not have to report an event if the event:

    • Resulted from a motor vehicle accident on a public street or highway, except in a construction work zone; employers must report the event if it happened in a construction work zone.
    • Occurred on a commercial or public transportation system (airplane, subway, bus, ferry, street car, light rail, train).
    • Occurred more than 30 days after the work-related incident in the case of a fatality or more than 24 hours after the work-related incident in the case of an in-patient hospitalization, amputation, or loss of an eye.

    Employers do not have to report an in-patient hospitalization if it was for diagnostic testing or observation only. An in-patient hospitalization is a formal admission to the in-patient service of a hospital or clinic for care or treatment.

    Employers do have to report an in-patient hospitalization due to a heart attack, if the heart attack resulted from a work-related incident.

    What to report

    Employers reporting a fatality, inpatient hospitalization, amputation, or loss of an eye to OSHA must report all of the following information:

    • The name of the establishment.
    • The location of the work-related incident.
    • The time of the work-related incident.
    • The type of reportable event (i.e., fatality, inpatient hospitalization, amputation, or loss of an eye).
    • The number of employees who suffered the event.
    • The names of the employees who suffered the event.
    • The contact person and his or her phone number.
    • A brief description of the work-related incident.

    How to report

    Employers can use the following three options to report an event:

    • Call the nearest OSHA Area Office during normal business hours.
    • Call the 24-hour OSHA hotline (800-321-OSHA or 800-321-6742).
    • Report an incident electronically (OSHA is developing a new means of reporting events electronically, which will be released soon and will be accessible on OSHA’s website).


    It is recommended that employers familiarize themselves with the final rule and train personnel accordingly. All employers under OSHA jurisdiction, even those who are exempt from maintaining injury and illness records, are required to comply with the new severe injury and illness reporting requirements.

    Read More …

  • When is a medical plan not a medical plan? When it is a dental plan…Exchange counts off

    December 29, 2014

    The Department of Health and Human Services has admitted that it made a mistake in counting the total enrollment under the Affordable Care Act by 380,000…because it counted dental plans as medical plans.  This allowed them to hit the “magic number” extolled by the administration of 7 million enrollees, thus hitting their target and claiming enrollment a success.  Secretary Burwell apologized, saying “this mistake was unacceptable (but) the fact that we have quickly corrected the numbers should give people confidence”

  • Proposed 2016 Benefit and Payment Parameters | California Benefits Broker

    December 26, 2014

    Tags: , , , , ,

    Posted by Linda Rowings

    2016healthcareThe Department of Health and Human Services (HHS) has issued its proposed Benefit and Payment Parameters for 2016. While these amounts and dates are not yet final, they may be of help for planning purposes. At this time, HHS expects:

    • Open enrollment for coverage through the Marketplace in 2016 will be from October 1 through December 15, 2015 (with coverage effective as of January 1, 2016).
    • The transitional reinsurance fee for 2016 is likely to be $27 per covered life. Filing for 2016 would be due November 15, 2016, with $21.60 per covered life due January 15, 2017, and $5.40 per covered life due November 15, 2017.
    • The out-of-pocket limits for health plans that are not high deductible plans related to HSAs would be $6,850 for single coverage and $13,700 for family coverage (with a maximum out-of-pocket for any family member of $6,850).
    • The federally facilitated exchange fee would remain at 3.5% of premium.
    • A special enrollment period would be available at renewal for individuals enrolled in non-calendar year plans.
    • Retirees and COBRA participants could be covered through a Small Business Health Options Program (SHOP) plan.
    • The current benchmark plans for essential health benefits would remain in effect for 2016, with new benchmark plans based on 2014 benefits and enrollment in effect for 2017.

    A draft of an updated AV calculator and methodology for 2016 also are available. While this will help you stay forward-thinking, don’t forget about taking steps to ensure you are prepared to meet the Patient Protection and Affordable Care Act (PPACA) requirements that begin in 2015 and those which must be completed in 2014. For a complete checklist, download UBA’s PPACA Advisor, “Preparing for 2015 – Key PPACA Requirements”.

    Read More …

  • It was not well suited to their needs – so they are filing suit against it – GOP vs. Obama

    December 23, 2014

    They didn’t like the bill, now they don’t like the fact that it is not happening fast enough.  Accusing President Obama of “making up his own laws” (John Boehner) by delaying the employer mandate, the Republicans are also considering filing a suit over the recent decision to provide deportation relief.  They’re not related, except insofar as it concerns the Chief Executive.  House Minority Leader Nancy Pelosi was a bit upset : “the fact is, this lawsuit is a bald faced attempt to achieve what Republicans have been unable to achieve through the political process.  The legislative branch cannot sue simply because they disagree with the way a law passed by a different Congress has been implemented…the lawsuit is an embarrassing loser.”

  • Hand Washing Helps Defeat the Flu | Petaluma Benefits Broker

    December 22, 2014

    Tags: , , ,

    handsH3N2 influenza viruses led to record numbers of deaths in the 2004, 2008, and 2013 flu seasons. Doctors are concerned because this type of virus appears to be dominating the 2015 flu season. Employers should stress optimal health and hand-washing behaviors in their workplaces to avoid the threat of flu and keep their workplaces healthy and germ-free.

    The United States Centers for Disease Control (CDC) reports a majority of cases so far this flu season are H3N2 viruses. When these types of viruses are the most prevalent in a flu season, the result is often more severe illness with greater instances of hospitalization and death. This year the CDC is finding that the flu vaccine’s ability to protect against H3N2 viruses is not as strong as was hoped when the vaccine was being formulated. This reduced protection is the result of mutation in about half of the H3N2 viruses since the season began. The CDC still recommends the vaccine as vaccinated people will likely have a more mild illness if they do become ill. This warning will help employers to see the need to augment vaccination with other preventive health measures.

    Effective hand washing is essential to prevent the spread of infectious disease. The bacteria, viruses, and other microbes that spread infection usually are not visible to the naked eye. Everyone should care about the spread of harmful organisms because everyone has the potential to unknowingly spread them to a person with a compromised immune system. Examples of those with compromised immune systems include family members, particularly children and the elderly, or co-workers coping with illnesses like cancer, heart disease, or diabetes.

    Hands should be washed frequently. You may be surprised to discover how many times you inadvertently touch your face in the course of a day, which is often the method that introduces contaminates to our bodies through our eyes, nose, or mouth. At a minimum, wash your hands several times per day to lessen the risk of inadvertently spreading harmful organisms.

    Wash hands both before, during, and after food preparation as well as before eating, treating a wound, or adjusting contact lenses. Hands may need to be washed multiple times during food preparation. For example, Salmonella is a bacteria that can be found on raw meats and vegetables, and is a serious concern in the United States. According to the CDC, each year over one million people acquire the illness, leading to 19,000 hospitalizations and 380 deaths. In addition to cooking food properly and cleaning work surfaces, Salmonella  abatement requires hands to be cleaned before handling cooked meat or other ingredients to prevent the transfer of organisms from raw items.

    To minimize the spread of respiratory infections and diarrheal illness, wash hands after using the toilet, coughing, blowing your nose, changing a diaper, or touching garbage, soiled laundry, shoes, an animal, or anything touched by an animal. This preventive step lessens the amount of germs transferred to key boards, handrails, door knobs, or toys.

    Soap and Water

    Soap and clean running water are two elements of optimal hand washing. The surfactants in soap lift soil and microorganisms from the hands, enabling the running water to carry the undesirable elements away without posing the risk of recontamination caused by standing water. Water of cool or warm temperature works equally well in removing undesirable organisms. Another helpful part of the process is the mechanical action created when hands are scrubbed or rubbed together continuously.

    Best practice for hand washing requires wetting the hands, turning the water off to prevent waste, applying soap, and spreading the soap across all surfaces of your hands for 20 seconds, being sure to include fingernails, back of hands, and wrists. Importantly, don’t rush the hand-washing process. Often parents will teach children to wash hands to the time it takes to sing the A-B-C song or another jingle that reliably takes 20 seconds. After scrubbing for 20 seconds, rinse hands thoroughly under running water. If the faucet is not operated by a sensor, use a towel or your elbow to turn it off in a manner avoiding hand recontamination. Finally, dry hands with a clean cloth, new disposable towel, or air blower.

    Alcohol as an Alternative

    An alcohol-based sanitizer can be an effective alternative to soap and water where a sink or clean water is unavailable. Examples of locations where sanitizer may be practical include conference rooms, break rooms, reception areas, or just outside of restroom doors.

    According to the CDC, effective use of waterless hand sanitizer requires an alcohol-based solution containing at least 60 percent alcohol. For hand sanitizers to be effective, it’s important that enough solution is used, that it stays on the skin and is not wiped or washed off prematurely, and that the solution is allowed to thoroughly dry on the skin.

    Similar to the use of soap and water, mechanical action or friction caused by scrubbing or rubbing hands together is essential for waterless hand sanitizer to stop the spread of microorganisms. Additionally, the hands must be free of organic matter prior to applying hand sanitizer. Using the appropriate amount of sanitizer requires placing enough sanitizer to cover a dime in the palm of one hand. Hands must then be rubbed together in a manner that covers all surfaces, including the back of the hands, until they are dry.

    Read More …

  • Gruber stake is Uber mistake…Obamacare architect shares too much

    December 22, 2014

    A series of videos have been released of various conferences and conversations involving Jonathan Gruber, who was one of the writers of the original ACA legislation, and they are not flattering…to anyone involved.  A sampling:

    “Lack of transparency is a huge political advantage.  Basically, call it the stupidity of the American voter of whatever, but basically that was really, really critical to getting things to pass”

    “This bill was written in a tortured way to make sure the Congressional Budget Office did not score the mandate as taxes (because) if CBO scored the mandate as taxes, the bill dies” (even though President Obama kept insisting the mandate was not a tax)

    “If you had a law which…made explicit that healthy people pay in and sick people get money, it would not have passed”

    “If you’re a state and you don’t set up an exchange, that means your citizens don’t get tax credits” (which is enlightening given that the Supreme Court is hearing on this issue right now, while the Obama administration is insisting that the Federal Exchange can offer subsidies)

    “It turns out politically (the employer subsidy) is really hard to get rid of…and the only way we could get rid of it was first by mislabeling it, calling it a tax on insurance plans (referring to the nascent Cadillac tax) rather than a tax on people when we all know it’s a tax on people who hold those insurance plans”  “What that means is the tax that starts out hitting only 8% of the insurance plans essentially amounts over the next 20 years essentially getting rid of the exclusion for employer sponsored plans…this was the only political way we were ever going to take on one of the worst public policies in America”

  • 2015 Cost-of-Living Adjustments | Petaluma Employee Benefits

    December 18, 2014

    Tags: , , , ,

    Posted by Linda Rowing

    moneyMany employee benefit limits are automatically adjusted each year for inflation (this is often referred to as an “indexed” limit). The Internal Revenue Service and the Social Security Administration have released a number of indexed figures for 2015.

    Limits of particular interest to employers include the following.

    For health and Section 125 plans:

    • The health flexible spending account (HFSA) maximum employee contribution is increasing to $2,550.
    • The maximum out-of-pocket limit that applies to non-grandfathered group health plans that are not coupled with a health savings account (HSA) will be $6,600 per individual and $13,200 per family.
    • The maximum out-of-pocket for a high deductible health plan coupled with an HSA will increase to $6,450 per individual and $12,900 per family.
    • The minimum deductible for a high deductible health plan coupled with a health savings account (HSA) will increase to $1,300 per individual and $2,600 per family.
    • The maximum HSA contribution will increase to $3,350 for individual coverage and $6,650 for family coverage. The catch-up contribution (available to those aged 55 and older) remains at $1,000.

    For qualified plans:

    • The annual deferral for 401(k), 403(b), and most 457(b) plans will increase to $18,000.
    • The catch-up contribution limits (available to those aged 50 and older) will increase to $6,000.
    • The threshold for “highly compensated employees” will increase to $120,000.
    • The threshold for an officer to have “key employee” status remains at $170,000
    • The annual compensation limit will increase to $265,000

    Social Security/Medicare Withholding:

    • The taxable wage base will increase to $118,500
    • The OASDI tax rate remains at 6.2%
    • The Medicare tax rate remains at 1.45%

    Request a quick reference chart from your local UBA Partner Firm.

    Read More …

  • SHOP until you drop…it…sales are not what were expected on Exchange group plan

    December 18, 2014

    The attention was all paid to the individual plans that suddenly made health care “affordable” – if you received a subsidy (from which the federal government is backpedaling furiously).  But alongside the individual plans the government decided that doing group insurance was a necessity…and it is the only vehicle that allows for the receipt of the small group health insurance tax credit.  This was supposed to help sales, even though the first two years of the program qualification was open for any plan, and barely taken (especially in California).  So now there is no surprise to find that the sale of the SHOP plan has not met expectations.  Difficulty in service, the lack of flexibility in choice, narrow networks and other problems do not make it palatable in the market, and thus less than 12,000 businesses signed up in the first 8 months.

  • Identify yourself…unless of course you can’t figure out how to do it – HIPD suspended

    December 17, 2014

    It seemed like a good idea at the time…have all plans of a certain size set up a Health Plan Identification Number.  But then, the day before it was to go into effect, the federal government suspended action.  It appears even the sharpest business people who tried to simply register a number had too much difficulty in doing so.  A report was made to the DOL saying that it should be set up for additional consideration.  More ACA delays…

Español »