Employee Benefit Consultants,
Risk Managers and Administrators

Since 1976

January 2018 Newsletter

Dr. Martin Luther King, Jr. Holiday is Monday, January 15, 2018

"The Martin Luther King, Jr. holiday celebrates the life and legacy of a man who brought hope and healing to America. We commemorate as well the timeless values heMartin-Luther-King-Jr-Birthday-1929-1968.jpg taught us through his example — the values of courage, truth, justice, compassion, dignity, humility and service that so radiantly defined Dr. King’s character and empowered his leadership."

by Coretta Scott King, The Meaning of the King Holiday www.thekingcenter.org






IRS Extends Deadline for Employers to Furnish ACA Statements to Individuals;

Due March 2, 2018  

1095-C-2017-extended1095-C to Individuals Deadline Extension: The Internal Revenue Service (IRS) issued Notice 2018-06 and announced it extends the due date for furnishing to individuals the 2017 Form 1095-B, Health Coverage, and the 2017 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, from January 31, 2018, to March 2, 2018.

Insurers, self-insuring employers, other health coverage providers, and applicable large employers must furnish statements to employees or covered individuals regarding the health care coverage offered to them. Individuals may use this information to determine whether, for each month of the calendar year, they may claim the premium tax credit on their individual income tax returns. This 30-day extension is automatic. Employers and insurers don’t have to request it.


The due dates for filing 2017 information returns with the IRS are not extended. The due dates to file information returns with the IRS are:

This notice also extends transitional good-faith relief from penalties to the 2017 information reporting requirements for filing inaccurate information under IRC §6055 (Minimum Essential Coverage MEC)  and §6056 (Applicable Large Employers ALE).  
  • Feb. 28, 2018 for paper filers
  • April 2, 2018 for electronic filers

Because of these extensions, individuals may not receive their Forms 1095-B or 1095-C by the time they are ready to file their 2017 individual income tax return. While information on these forms may assist in preparing a return, the forms are not required to file. Taxpayers can prepare and file their returns using other information about their health coverage, such as a W-2 form. They do not have to wait for Forms 1095-B or 1095-C to file.

Transition Relief Continued: This notice also extends transitional good-faith relief from penalties to the 2017 information reporting requirements for filing inaccurate information under IRC §6055 (Minimum Essential Coverage MEC)  and §6056 (Applicable Large Employers ALE).  

Tax+Reform+MGN.pngTax Reform Repeals ACA's Individual Mandate

On Dec. 20, Congress passed the Tax Cuts and Jobs Act, which makes significant changes to individual and corporate provisions of the U.S. tax code, including a reduction in the corporate tax rate to 21%, down from 35%, beginning in 2018. The bill includes permanent effective repeal of the Affordable Care Act (ACA) individual mandate, requiring individuals to purchase and maintain health coverage, by zeroing out the penalty beginning in 2019. For 2018, most individuals are still required to maintain coverage or pay a penalty when they file their 2018 federal income tax return.

COBRA and Gross Misconduct

COBRAThe Northern District Court of Alabama held in Knight v. Gen. Telecom, Inc. (ND. Ala. 2017) that a former employee could raise issues against his former employer for failing to provide a COBRA notice, despite termination for gross misconduct.  In ruling without a trial that the employee did not receive a proper COBRA election notice, the court examined the facts regarding the termination which included review of actions taken by the employer that established that the employee was not terminated for gross misconduct but the issue was raised when a request for coverage arose.

The facts are complicated, but when the employer determined that the employee was not following rules in the workplace and was counseled for habits that did not rise to the level of gross misconduct, the employer raised issues related to the employee’s claim for unemployment benefits.  Raising the issue of COBRA’s gross misconduct rules means that the employee and any covered dependent will lose the right to elect COBRA coverage. Establishing that an employee acted in a way to require termination for gross misconduct is a finding that is serious because it involves a total loss of benefits. The stakes are high for the employer as well, because if the employer is found to not have met the level of gross misconduct, the employer can face an award of retroactive COBRA coverage and a penalty of $110 per day for failing to provide a COBRA election notice required under ERISA.  The court in this case stated correctly that a definition of gross misconduct is not included in ERISA, and is a designation reserved for the most flagrant conduct in the workplace that can lead to substantial and willful disregard of the employer’s interest or safety.  Employers should be advised to get advice of Counsel before seeking to use gross misconduct and before making the decision of failing to provide a COBRA notice to a terminated employee.

Cybersecurity Advice to Maintain HIPAA Safeguards, Healthcare Cybersecurity on Vacation

Cybersecurity threats don’t take a holiday when you do. If you’re headed out of the office for an extended absence, be aware that cyber threats continue. In fact, some threats may be at an increased risk if you’re outside of the familiar, protected environment of the office or home.

When traveling, you must take extra precautions to safeguard personal and sensitive information you carry inside your phone, laptop, and tablet. You can protect yourself and others by leaving any equipment that you won’t need behind (just make sure it’s secure where you leave it). If you do need to take your work-issued computer and personal internet-connected devices, be sure to add these to-dos to your travel preparedness list.

Bring and Use Your Own Power Adapters and Cords-Cyber thieves may install malware onto hotel lamps, airport kiosks and other public USB charging stations. If you absolutely must charge your device on the road, and you don’t have access to your charger/adapter, power down your device before you connect it into any airport chair or public USB charging station.

Back Up Your Electronic Files- And make sure your back-ups are encrypted and secure!

Install Security Updates and Patches-Updates and patches can fix security flaws and enable security software to detect and prevent new threats.

Create New Passwords and Change Passwords

 add multi-factor authentication, if possible. Consider using a passphrase – a combination of words that are easy to remember, such as “Mydogatemyhomeworkandgotindigestion”. Once you’re home, change your passwords again!

Lock Devices Down-Most smartphones, laptops, and tablets come equipped with security settings that will enable you to lock the device using a PIN or fingerprint ID.

Remove or Encrypt Sensitive Information on Mobile Devices-If you do not need to access sensitive information while traveling, don’t bring it. But if you need the information while you are traveling, make sure sensitive information is encrypted. 

Turn Off WiFi Auto-Connect and Bluetooth-Cyber thieves can connect to your device in a number of different and easy ways.

Bring and Use Your Own Power Adapters and Cords-Cyber thieves may install malware onto hotel lamps, airport kiosks and other public USB charging stations. 

Avoid Public WiFi-Using your mobile network (like 4G or LTE) is generally more secure than using a public wireless network.

Ensure Physical Security of Your Devices-NEVER let your devices leave your sight. If you cannot physically lock devices in your hotel room safe or other secure place, take them with you. There are no good hiding spots in your hotel room! Many breaches occur because a device was left unattended when an opportunistic thief struck. When traveling with laptops and tablets, the best protection is to carry them with you. It’s never safe to pack your devices in your checked luggage.

Create Unique PINs-Don’t use the same PIN for the hotel safe and a mobile device.

Use Geo-Location Cautiously-This tells thieves back home that you are away, which is a great time to break in. 

For HIPAA Covered Entities and Business Associates-The HIPAA Security Rule requires that covered entities and business associates conduct a risk analysis to identify risks and

vulnerabilities and to mitigate identified threats and vulnerabilities. Risks to ePHI created, received, maintained, or transmitted on workplace owned equipment, and personal equipment if permitted, when workforce members travel must be included as part of a covered entity’s or business associate’s risk analysis and risk management process.


Source: Office of Civil Rights, December, 2017 Cybersecurity Advice to Maintain HIPAA Safeguards, Healthcare Cybersecurity on Vacation 

Self-Funding 101: 

Is Self-Funding Right For My Business?

Assessing the Whole Picture
Self-funding (often referred to as self-insurance) can have many advantages for both private sector and public employers, including more input in health plan design and better control over rising medical benefit costs. It isn’t the right fit for every employer, though, and making the switch takes some careful consideration and in-depth analysis.self-funded image.jpg

Many employers will start the process of research and discovery by having their HR team work with prospective third party administrator (TPA) firms to determine feasibility.

As the two parties meet, these are just some of the points that are typically addressed:

Financial Situation – The employer/plan sponsor will assume the risk of the health plan instead of the insurance carrier. Because of this, it is important to look at the overall fiscal picture. What is your company’s financial history? Has it been stable over the last several years? Do you have sufficient reserves on hand?

Cash Flow – In the case of most fully insured plans, employers pay a set rate in monthly installments for group benefits. This is different with self-funded plans, as employers must cover health claim costs as they’re incurred. That means the month-to-month expenses could vary significantly as ups and downs are experienced throughout the year. There is also stop loss insurance to budget for, so it’s essential to have a steady cash flow.

Risk Tolerance – As mentioned above, the employer/plan sponsor is the one to assume the risk in a self-funded plan. Is your company prepared to take this on and cover any potential loss before stop loss kicks in?

Coverage Needs – Does your plan have special health coverage needs or are you hoping to offer extra medical benefits? Knowing and sharing your ultimate goals helps determine how self-funding can make a difference for your company and employees.

Administration and Compliance – Unlike a fully insured plan, the majority of administration and compliance functions officially fall to the employer when self-funding your group benefits. These added responsibilities are typically managed with the help of a TPA.

The Best Health Plan for Your Workforce?
The self-funding industry continues to grow as companies of all types and industries across the U.S. choose this plan model to offer group benefits. To decide if this structure is right for you and your workforce, there are a number of factors to consider. These include everything from the financials, funding and risk tolerance to claims data, desired health coverage and resources available to manage administration and compliance.  Contact us to discuss if self-funding is right for your business at 704-525-9666.

Article from Self Funding Success.com 

Infographic for Pharmacy Trend*

* Source: http://blog.medcost.com/wp-content/uploads/2017/04/Explaining-Pharmacy-Trend.png

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Tucker Administrators, Inc.

3800 Arco Corporate Drive
Suite 450
Charlotte, NC 28273

Phone: 704-525-9666
Fax: 704-525-9534