by Admin. | Mar 28, 2019 | NJ
On March 1, 2019, New Jersey established a transit benefits requiring employers to offer employees pre-tax commuter transit benefits.
Background
Qualied transportation fringe benets under Section 132(f) of the Internal Revenue Code allow an employer to provide commuter and transit benets to their employees that are tax-free up to a certain limit. This employer-provided voluntary benefits program allows employees to effectively reduce their monthly commuting or transit costs. In 2019, the monthly limit is $265 for any commuter benet or transit pass. While such benefits provide a tax benefits to employees, under the 2017 Tax Cuts and Jobs Act, employers are no longer allowed a federal income tax deduction for qualied transportation fringe benefits. The Act also requires tax-exempt employers to pay unrelated business income taxes on such benefits.
New Jersey Requirements
Covered employers in New Jersey will be required to offer a pre-tax transportation fringe benet to their employees. It appears that covered employers means employers with at least 20 employees, regardless of whether they all work in the State of New Jersey; however, clarication from the regulators on this would be helpful.
An employee under the new law is identied as anyone hired or employed by the employer and who reports to the employers work location, and mirrors the denition used in the unemployment compensation law. Certain temporary or limited exceptions exist for employees covered by a collective bargaining agreement and those employed by the federal government.
Some of the details regarding implementation of the program are still outstanding and the Commission of Labor and Workforce Development will adopt rules and regulations concerning the administration and enforcement of the benefit. Civil penalties will apply for non-compliance with this new law.
Some of the details regarding implementation of the program are still outstanding and the Commission of Labor and Workforce Development will adopt rules and regulations concerning the administration and enforcement of the benefit. Civil penalties will apply for non-compliance with this new law.
Employer Action
While the ordinance takes effect immediately, it will not be enforced until final rules and regulations are released. The earliest enforcement is anticipated to be March 1, 2020, but is subject to change. Employers should determine whether their current employee demographic would require these benefits to be offered to their employees. Employers currently offering transportation fringe benefits to employees should review their current program to ensure compliance with the final rules and regulations in New Jersey once those are released.
If you would like to know more about MMS Corp and pre-tax benefits for your company, contact us today.
by Admin. | Oct 17, 2018 | Disability, NJ
NJ Paid Sick Leave Law Update: Required Notice for Employers Released
Employers in New Jersey employers will be required to comply with the state’s new Paid Sick Leave Act on Oct. 29, and the state’s Department of Labor and Workforce Development has published both proposed regulations to implement the law and a new mandatory workplace poster.
Timeline
- The notice must be distributed to all existing employees by November 29, 2018
- The notice must be distributed to all new employees at the time of hire so it should be immediately added to New Hire Kits
- The notice must be posted in a place frequented by employees (such as a break room or communal area) by October 29, 2018
Benefit
The poster is a written notice. Employers must provide up to a total of 40 hours of earned sick leave every benefit year, with the worker accruing earned sick leave at a rate of one hour per 30 hours worked, up to a maximum benefit of 40 hours per benefit year.
Available use begins after 120 days from employment.
Cost
The program is financed by worker payroll deductions. Starting January 1, 2018, each worker contributes 0.09% of the taxable wage base. For 2018, the taxable wage base is $33,700, and the maximum yearly education for Family Leave Insurance is $30.33. The taxable wage base changes each year.
Claim Events
Acceptable reasons to use earned sick leave:
- The worker needs diagnosis, care, treatment, or recovery for a mental or physical illness, injury, or health condition, or he/she needs preventive medical care.
- The worker needs to care for a family member during diagnosis, care, treatment, or recovery for a mental or physical illness, injury, or health condition, or the family member needs preventive medical care.
- The worker or a family member has been the victim of domestic violence or sexual violence and needs time for treatment, counseling, or to prepare for legal proceedings.
- The worker needs to attend school-related conferences, meetings, or events regarding his/her child’s education or to attend a school-related meeting regarding a child’s health.
- The worker’s business closes due to a public health emergency or he/she needs to care for a child whose school or child care provider closed due to a public health emergency.
Click here for the employer notice. NJ Paid Sick Leave Law mw565sickleaveposter
Applying for Benefits
You can apply online for Family Leave Insurance benefits:
- At www.nj.gov/labor/fli2
- Download an application (DS-1) and mail to: Division of Temporary Disability Insurance PO Box 387, Trenton, NJ 08625-0387 or fax to (609) 984-4138 Request an application by phone (Customer Service Section): (609) 292-70
The information provided herein is not written or intended as tax or legal advice and may not be relied on for purposes of avoiding any federal tax penalties. Entities or persons distributing this information are not authorized to give tax or legal advice. Individuals are encouraged to seek specific advice from their personal tax or legal counsel.
by Admin. | Aug 6, 2018 | CT, group health insurance, Health Exchanges, healthcare, latest health insurance news, NJ, NY News, Obamacare, Small Business Group Health
NYS 2019 Final Rates Approved 
NYS has approved 2019 Final Rates last Friday. Small group rates will increase 3.8% and 8.6% for individuals.
As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers see original –NYS 2019 Rate Requests. Despite only 3 months of mature claims data experience for 2018 health insurers’ original requests were noticeably below average 7.5% for small group and 24% for individuals. Ultimately NYS reduced this request substantially by approximately 50%.
Experts are concerned over the long term effects. Example, the Individual mandate was removed last December by Presidential order. Without the Mandate anyone can drop insurance without penalty. A comparable take away for similar auto insurance industry would be something like this -Drivers ought not be mandated to buy auto insurance as its a profit scheme by Insurers. While a popular decision this will hardly bend the curve long term and reduce competition. Furthermore, the new order of Selling Across State lines makes NYS most unwelcoming.
OTHER STATES
Insurers have been filing to sell Obamacare plans that will go into effect in 2019, and in some states they appear to be pricing in for the fact that the mandate is going away next year. Other states are seeing mild increases, but that is in part because they saw significant hikes for the previous year.
Insurers have concluded that fewer people will enroll without the mandate than otherwise, so in some places they are pricing their plans higher based on the assumption that sicker people will be left behind, which will increase medical costs for those left. It is well worth pointing out that in recent years the loss federal risk reinsurance corridor funds account for 5.5 percent of the rate increase.
How are neighboring States doing?
In NJ, not that bad. Last year the average increase were 5.5% for small groups and some popular plans such as Horizon Blue Cross Blue Shield’s OMINA increasing only 4.8% increase. This year the increase is only 5.2. Other insurers offering EPO and HMO plans in the individual market for 2019 include Oscar Health and Oxford Health Plans.
With individual mandate repeal fewer people will buy health insurance raising the prices for those who do. NJ Banking and Insurance Department officials said premium prices would have increased, on average, by 12.6 percent.
For CT market, on the other hand, things are much worse at least for the individual marketplace with average 25% rate increases last year. The 2019 proposed rate increases for both the individual and small group market are, on average lower, than last year: The proposed average small group rate increase request is a 10.22 percent and ranges from -5.0 percent to 21.1 percent. This compares to the average increase request of 18.06 percent requested last year.The proposed average individual rate increase request is 12.3 percent and ranges from -10.9 percent to 31.0 percent. This compares to the average increase request of 25.51 percent requested last year.
Final plan rates in New Jersey & CT will be finalized and released in the fall, state officials said. ACA open enrollment begins Nov. 1
- Trend: Trend is a factor that accounts for rising health care costs, including the cost of prescription drugs, and the increased demand for medical services.
- Uncertainty in Washington:
- Removal of penalty for individual mandate: The elimination of the penalty means that individuals who are typically younger and healthier would have no inducement to participate in the insurance pool, which could further destabilize the market. Lack of participation shrinks the pool and increases the cost of insurance to the remaining members.
- Short-duration health plans and Association Health Plans: Still pending are final federal regulations on non-ACA compliant short-duration plans, which may have implications for the ACA risk pool. Also, Connecticut along with other state insurance regulators, are awaiting clarification from the federal government on new federal regulations allowing association health plans, which could further shrink the ACA risk pool.
A bipartisan group of congressional representatives has discussed an agreement to extend and guarantee the payments, but it’s unclear whether they could do so by the new filing deadline of Sept. 5. A lawsuit filed by Congress against the Obama administration to challenge the payments is still pending. In addition, Trump has repeatedly threatened to withhold payments to insurers that reduce cost-sharing – deductibles, copays and coinsurance – paid by low-income customers. More than half of New Jersey’s marketplace customers receive that assistance, and without it, most would be unable to afford coverage.
Finally, a tax on health insurance premiums has been reinstated in 2018 after a one-year “tax holiday” approved by Congress for 2017. That contributed 2.3 percent to the rate hikes that insurers requested for 2019 and for 2019
SMALL GROUP MARKET VS. INDIVIDUAL MARKET
Importantly, small group market is still more advantageous than individual markets unless one gets a sizable low-income tax credit. Overall, about 350,000 individual plan consumers will be affected by the price hike, while more than a million users will be hit by higher small group fees. Last year, Blue Cross Blue Shield released a study showing Obamacare user costs were 22 percent higher than people with employer-sponsored health plans, while UnitedHealth plans to exit most Exchanges see – Breaking: Oxford Exits Metro Indiv & Oxford Liberty HMO 2017.
The correct approach for a small business in keeping with simplicity is a Private Exchange and with our large buying group PEO partnerships. This is a true defined contribution empowering employees with a choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll. Both employee and employers still gain tax advantage benefits under the business. Also, the benefits, rates and network size are superior under a group plan as the risk are lower for small group plans than individual markets.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.
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by Admin. | Jun 12, 2018 | family health insurance, Health Care Reform, Individual Exchanges, individual health insurance, latest health insurance news, NJ
New Jersey Enacts Individual Health Mandate
A new law entitled the “New Jersey Health Insurance Market Preservation Act” was signed by Governor Phil Murphy on May 30, 2018 to reestablish the recently repealed “shared responsibility tax”. The law, which will take effect on January 1, 2019, will require every New Jersey resident to obtain health insurance with minimum essential coverage or pay a fee, essentially adopting the rules of the ACA.
This legislation will directly impact residents of NJ and indirectly affect employers with employees residing in the state.
State Individual Mandate
The New Jersey Health Insurance Market Preservation Act will require all New Jersey residents to have Minimum EssentialCoverage (MEC) beginning January 1, 2019, or pay a penalty.
In light of Federal repeal on Dec 29, 2017, Tax Reform Bill Includes Repeal of Individual Mandate Beginning in 2019, NJ’s mandate is scheduled to take effect on January 1, 2019, making NJ the second state, after Massachusetts, to enactan individual mandate. The mandate includes an annual penalty of 2.5% of a household’s income or $695 per adultand $347 per child – whichever is higher. The maximum penalty is based on household income and will not exceed theaverage yearly premium of a bronze plan.If it’s based on a per-person charge, the maximum household penalty will be $2,085.
A “hardship exemption” will be available for individuals who cannot afford coverage, determined by the State Treasurer. NJ expects to collect between $90 million and $100 million in penalties. This money, along with additional federal funding, willbe used on a reinsurance program, which Murphy also signed into law.
Employer Action
While these bills do not directly affect employer sponsored plans, the individual mandate requirement for NJ residents will likely require education for employees. As residents in NJ will now be required to obtain health overage to avoid a state income tax penalty, employers may see an increase in plan enrollment. Unlike Massachusetts which requires specific coverage components, the NJ law only requires that coverage be MEC. Thus, most traditional employer-sponsored group health plans should meet this definition. However, coverage for only dental benefits, certain medical indemnity policies and vision benefits are likely not sufficient for purposes of avoiding the state tax. For now, employers with employees who reside in New Jersey may wish to educate employees at Open Enrollment that by January 1, 2019 health coverage will be required for NJ residents to avoid a penalty.
Conclusion
New Jersey lawmakers feared the repeal would drive healthier people out of the marketplace causing premiums to spike. They believe this law is pertinent to stabilize the marketplace, keep people insured, and prevent a death spiral of the individual market.
Resource:Obamacare Indivudal Mandate & Individual Mandate ACA Flow Chart and https://www.healthcare.gov/fees/fee-for-not-being-covered/
by Admin. | Jun 3, 2018 | healthcare, NJ
No More Surprises – NJ Surprise Medical Bill Law
New Jersey Governor Phil Murphy (D) signs law to take in effect within 3 months that will reduce Surprise Out-Of-Network Medical Bills.This is well needed and in-step with NYS law passed 3 years ago – No More Surprises – NY Surprise Medical Bill Law.
The reform is designed to protect patients, businesses, and others who pay for medical care from the high-cost bills associated with emergency or unintentional care from doctors or other providers who are not part of their insurance network. The law requires greater disclosure from both 
insurance companies and providers — so patients are clear on what their plan covers — ensures patients aren’t responsible for excess costs, and establishes an arbitration process to resolve payment disputes between providers and insurers, a mechanism intended to better control costs.
The Problem. This has been a pattern in recent years and posted in Out of Control Out of Network Charges (March 2012). According to an investigation report commissioned by Governor Cuomo recognizing the unexpected out-of-network claim problem. Officials say that this is now “an overwhelming amount of consumer complaints.” Some examples cited in the report An Unwelcome Surprise – “a neurosurgeon charged $159,000 for an emergency procedure for which Medicare would have paid only $8,493.” Another example: ” a consumer went to an in-network hospital for gallbladder surgery with a participating surgeon. The consumer was not informed that a non-participating anesthesiologist would be used, and was stuck with a $1,800 bill. Providers are not currently required to disclose before they provide services whether they are in-network.” The average out-of-network radiology bill was 33 times what Medicare pays, officials say.
The blog post goes on to say “Today, 90% of SMB members have in network only benefits but the few remaining consumers are paying for eroding out of network benefits with little transparencies and necessary protection from new out of network billing practices. The NY Dept of Financial services is calling for providers in non-emergency situations to disclose whether or not all services are in-network, what out-of-network charges will be and how much insurers will cover.”
The Solution: The The out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act requires greater disclosure from both insurance companies and providers — so patients are clear on what their plan covers — ensures patients aren’t responsible for excess costs, and establishes an arbitration process to resolve payment disputes between providers and insurers, a mechanism intended to better control costs. The law sets a timeline and other parameters for negotiations between the payer and the provider and, if they can’t resolve the issue, requires the state to hire an independent expert to decide between the final offers presented by both sides. While earlier drafts of the bill included a range of factors for the arbitrator to consider in making this decision — including the doctor’s experience, the patient’s condition, and certain payment benchmarks — these details were eliminated entirely in the final version.
NJ becomes the 7th State to enact such consumer protection. The other states include California, Connecticut, Florida, Illinois, Maryland and New York.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us – info@medicalsolutionscorp.com or (855)667-4621.
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by Admin. | Oct 25, 2016 | individual health insurance, NJ
2017 NJ Individual Health Plans 
NJ Dept of Banking and Insurance posted the 2017 NJ individual health plans Monday. Only two carriers will offer plans on the state’s Obamacare marketplace next year: Horizon Blue Cross Blue Shield of New Jersey and AmeriHealth.
Additional insurers are participating off-exchange or outside the Marketplace. Examples: Aetna, CIGNA and Oxford. There are additional 20 plan options available off exchange. A notable new entrant, Health Republic of NJ, will no longer be available for 2017. See – Health Republic NJ Shutting Down.
Here are the 2017 rates:
2017-new-jersey-individual-health-benefits-plans-and-rates
