HR & Employee Benefits Newsletter WA Group

Connect The Dots: May 2024

Law Alert: Pregnant Workers Fairness Act
By: Mineral

The final rule for the Pregnant Workers Fairness Act (PWFA), which applies to employers with 15 or more employees, has been published and takes effect June 18, 2024. With over 100 pages of preamble, regulations, and interpretive guidance, there’s obviously a lot to take in. Thankfully, you don’t need to spend a whole afternoon reading unless or until you’re considering denying an accommodation—that’s when you should take a close look at what the Equal Employment Opportunity Commission (EEOC) has to say to ensure you’re compliant.

Compliance Corner
By: Benefit Comply

Opt-Out Incentives (Cash-in-Lieu of Benefits)

Some employers choose to offer an opt-out incentive or cash-in-lieu of benefits for eligible employees and their family members who waive the benefits offered by the employer. For example, the employer may offer a monthly cash incentive to those who waive the employer’s offer of medical coverage. In some cases, the employer may use this as a strategy to encourage individuals not to enroll in the employer’s benefits, potentially reducing the plan’s claims exposure. In other cases, the employer may be looking for ways to provide additional benefits to those employees who have coverage options available elsewhere. In either case, such incentives are generally permitted subject to any carrier restrictions, but there are several compliance factors to consider.

Maximizing Estate Planning with Insurance: Navigating the Sunset Exemption and State Taxes
By: WA Group

As we approach the sunset of the federal estate tax exemption in 2026, individuals and families must consider not only federal tax implications but also the thresholds for state estate taxes, which can vary significantly. Understanding federal and state estate tax thresholds is crucial for effective estate planning.

The federal estate tax exemption, currently at a historically high level, is set to revert to pre-2018 levels in 2026, potentially impacting estates exceeding this threshold. However, in addition to federal taxes, you must also contend with state estate taxes, which have their own set of rules and exemptions.

In light of both federal and state tax considerations, life insurance emerges as a valuable tool for estate planning, offering solutions to offset potential tax liabilities and preserve wealth for future generations:

  1. Liquidity Solution: Life insurance provides immediate liquidity to cover estate taxes, ensuring that heirs have the funds to settle tax obligations without the need to sell off valuable assets hastily.
  2. Estate Equalization: Insurance can help equalize inheritances among heirs, particularly in cases where the bulk of the estate consists of non-liquid assets such as family businesses or real estate.
  3. Tax Offset: The tax-free death benefits of life insurance can be used to offset both federal and state estate taxes, effectively reducing the overall tax burden on the estate.
  4. Dynasty Planning: Insurance within a properly structured trust can facilitate dynasty planning for families with substantial wealth, creating a perpetual source of tax-free wealth transfer across generations.

Employers must consider federal and state estate tax thresholds to navigate the complexities of estate planning. Strategic use of insurance can help mitigate tax liabilities and preserve legacies for future generations. Consultation with a qualified financial advisor or estate planning attorney is recommended to tailor strategies to individual circumstances and maximize benefits under federal and state tax laws.

Empower Your People
By: VAST University

Here is a story from our VAST U Coach. The takeaway is, question everything. There are over 75,000 different CPT codes. When the wrong CPT code is used, it may mean a higher cost to the member. One simple question saved this person $1,200!

“My Dr. recommended a lung CT scan being I qualified for it, in my annual visit last December. In January when I was going to schedule it, I was told by my Dr office it would cost around $1200. So I didn’t do it thinking if it was recommended from an annually visit and I qualified, insurance should cover it. Then in March I received the approval. Now I was ready to do this being approved from this letter, to find it has an expiration date of 4/11/24. Do I need to get Dr office to resend for approval again? This letter doesn’t really say what would be covered, any way of finding this info out? Your assistance in this matter would be helpful.”

Response from their VAST U Coach: “After discussing with insurance carrier. I explained to the employee what to tell his provider on how to code for both the CPT code and the diagnoses code so as not to pull under the medical benefit but to pull under routine. I also told the employee who his provider needed to contact to extend the prior auth to allow time for this and it saved the employee $1200. Employee meets definition for this screening to be covered under preventive so should never have to pay the $1200.”

Upcoming Webinars

Medicare Coordination with Employer-Sponsored Coverage

Presenters: Bob Radecki, Principal, Benefit Comply LLC & Regan Debban, J.D. MBA, Principal, Benefit Comply LLC

An aging workforce requires employers to better understand how Medicare options coordinate with employer benefit offerings. We’ll touch on coordination of benefit rules, creditable coverage status, how Medicare impacts HSA eligibility and COBRA continuation options, and more.
May 23, 2024 @ 2pm
Registration link: https://assurexglobal.zoom.us/webinar/register/WN_S2MUW_QaTfGxaKdgUd2jQ#/registration

 

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