HUB International's Chief Compliance Officer, Sibyl Bogardus, delivers a comprehensive review of Health Care Reform & Benefit changes that are coming and what employers need to do to be prepared.

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March 31 Webinar

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8. Sibyl Bogardus provides compliance and consulting advice regarding employee benefits. Areas of
expertise include federal healthcare reform, HIPAA, ADA, wellness, labor laws, COBRA, ERISA,
FMLA, and compliance with tax requirements.
Sibyl has been named as one of the 100 Leading Women in insurance by Business Insurance and
one of the 25 Most Influential Business Women by the St. Louis Business Journal.
She is a nationally recognized speaker on healthcare reform, medical plan design trends, state and
federal laws, and human resources issues.
A widely-published author on healthcare reform, employee benefits, tax, and labor law issues,
Sibyl publishes articles each month in Health Reform Magazine. She is on the Editorial Advisory
Board of Benefits Quarterly, a publication of the International Society of Certified Employee Benefit
Specialists. She has given interviews for radio, magazines, and newspapers.
Sibyl
Bogardus
Chief Compliance
Advisor, Attorney

9. Click to edit Master title styleEmployee Benefits Legal Update:
Your Guide to Avoiding Legal Landmines
and Pitfalls in 2015
HUB International
Sibyl Bogardus
Chief Compliance Officer
© All Rights Reserved 2015

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Agenda
• Tough - and valuable - lessons from 1/1/15 enrollments
and rollout of group health reform
• Will technology catch up to legal requirements?
• Effects of individual exchange enrollment, subsidies, and
premium payments
• The Supreme Court case - key dates and likely outcomes
• A Republican Congress - what we expect in 2015 & later
• Increased DOL & IRS audit activity – impact on you
• Dealing with 2015's top five expected developments

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So, How Did THAT Feel?
Tough & valuable lessons from 1/1/15
enrollments & rollout of group health reform
• Communications
o Benefit guide re-alignment
o Enrollment meetings (“It lasted how long?”)
o Typical employee questions and concerns
• Enrollment percentages & changes
o Traditional core health plans
o Minimum value skinny

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So, How Did THAT Feel? (cont.)
Tough & valuable lessons from 1/1/15
enrollments & rollout of group health reform
• Nontraditional plans
o ELAP (Medicare plus a percentage)
o Supplements
o Skeletons?
o No hospitalization…RIP
• Renewals / rate changes
o Large group
o Small group
o Fixed costs for self-funded plans

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Key C-Suite Goal:
No Surprises on Additional Costs
• Opportunities to minimize financial and administrative
impacts
o The challenge: Migraine inducing, right?
o One answer: Technology, but who is ready?
• Standards for compliance in 2015/2016
o Budget for the offer
70% moving to 95%
Individual penalty impact
o Good faith on reporting
• Making a business case
o Who will be your internal partner? External?

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Advance Planning Remains Crucial
Why and how to create a 3-5 year strategic
plan for healthcare reform
• The grid to guide you
• Work in flexibility
o Ongoing changes with agency interpretations
o Cadillac tax
o Need for fallback strategies
• Financial analysis for self-funding
• Monitor new benchmarks and approaches

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Are Your Systems Ready?
• Tracking
o Hours worked, PTO, FMLA, Military Leave, jury duty
o Changes in position or job status
• Gathering date & reporting to employees & IRS
o Draft forms
o Impact as enforcement tool
• Premium adjustments and other nuances
Will technology catch up to legal requirements?

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Staying on Top of Practical Issues
• Variable hour and seasonal classifications
o Practical implications of premium collection
o Changing status of an employee:
Change to full-time (new hire … or other?)
Change to part-time (variable hour or full-time?)
“Wasn’t there another rule on…?”
o Leaves of absence
o PTO accruals
o Rate of pay changes
o Changing measurement periods
Remember – 70%! And remember to…Breathe!

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Your employees are asking…
”What is happening?”!
Effects of individual exchange enrollment,
subsidies, and premium payments
• Inappropriate subsidies
• “Unique perspective” of state exchanges
• Pitfalls for the unwitting
o Uncoordinated & inadequate information
o Claw backs
• Beware unions & staffing/temp/ PEO firms
• “Help me with $, information/advice, tax forms”

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Keep Employee Engagement
Facilitate human capital management
in the midst of these changes
• Cultural considerations
• Matching processes internally
• Avoid the Siren Song of public exchanges
• Education -- re-focus and emergence of "new" tools

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What will the Court Say?
• The Supreme Court case
o Subsidies for citizens in state exchange (not federal?)
o Current # of state exchanges
• Key dates
o Arguments in March
o Decision before July 4th
• Possible outcomes
o Subsidies in any exchange
o Subsidies only in state exchanges
• Then what?
• Likely outcome…wait for it…wait for it….

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Impact of Politics?
• Republican Congress
o 2/3
• Upcoming Presidential election
• What we expect in 2015 & later
o Hours adjustment to 40?
o Penalty elimination
o Mandate elimination
o Repeal? Or repeal & replace?
o The big fix in July, August, later

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Implementation & Changing
of the Guard in 2016
• Expect a push & prepare for disruptive changes
• Want to get involved?
o Deal with facts: Regulatory agenda
o Federal requests for input
• Comment if an issue is important to you
o Example: k-12 substitute teachers
• Dual path -- compliance + advocacy

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An Audit – How will that feel?
• Increased DOL & IRS audit activity
o Foreshadowing!
• Triggers
o Complaints
o Reporting
o Timing
• Immediate impact on you
• Fallout
o Cross-referrals
o Vendor impact
o The follow-through

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Staying Out of Trouble
How to avoid the scams and shams
the IRS will be targeting in audits
• Individual policy payments or reimbursements
• Unearthing skeletons in your benefits closet
• Defined contribution software
• Payroll tax avoidance schemes
• More war stories
And don’t forget the DOL
• Employee communication
o Fiduciary responsibilities
• Building your Fiduciary File

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Staying Ahead of the Curve
• What works, what doesn’t, and how to avoid
the wrong path
• Consider pros & cons
• Strong Trend: Collaboration
• Using influence – the “solution solution”
• Sample considerations for Cadillac Tax
o Supplemental benefits
o Eliminating the health plan
o Skinny plan options – not for everyone
o Self-funding
o Budgeting

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Sweat (& Document) the Small Stuff
Example: Affordability safe harbors
• Three possible safe harbors
o W-2, Rate of Pay, Federal Poverty
• Practical application
• What about non-safe harbors?
Memorialize the path you have taken
Similar issues: waiting period, non-health eligibility,
measurement and coverage rules, transition relief for
effective date or delay, class outs, etc.

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Sweat (& Document) the Small Stuff
Example: Employee Categories
• Variable hour, seasonal, and full-time
• Elimination of other categories for health benefits
• How to establish status
o With employees
o In HR documentation
• Addressing other benefits
Memorialize the path you have taken

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Top 5 Expected Developments in 2015
1. Discrimination rules for insured plans
2. Final Forms 1095-C and related forms and instructions
for employee & IRS
3. Small employer guidance
• Effective dates
• Other… like required notices?
4. Automatic enrollment (200+ employees plus)
5. Cadillac Tax
• Perhaps as request for input

28. Q & A

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30. Click to edit Master title styleThank You!