IRS Announces 2022 Limits for Health FSAs and Transit Benefits

IRS Announces 2022 Limits for Health FSAs and Transit Benefits

The Internal Revenue Service (IRS) announced annual inflation adjustments for more than 50 tax provisions, including an increase in voluntary employee contributions to employer-sponsored healthcare flexible spending arrangements (HFSAs) to $2,850 for plan years beginning in 2022, up from the 2021 limit of $2,750.

For HFSAs that include a carryover provision, up to $570 may be carried over from the 2022 plan year to the next plan year. Note that HFSAs had the option of allowing an unlimited carryover for the 2021 plan year due to federal COVID-19 relief provisions. For unused HFSA funds at the end of the 2022 plan year, however, the plan cannot allow more than $570 to be carried over for use in the following year.

The IRS also announced an increase in the 2022 monthly limits for qualified transportation fringe benefits under Code § 132(f). For transportation in a commuter highway vehicle and mass transit passes, the limit will be $280 (up from $270 this year). The separate monthly limit for qualified parking also will increase to $280.

Details of this announcement can be found in Revenue Procedure 2021-45.


By Kathleen A. Berger, CEBS

Originally posted on Mineral

Tips for Managing the Holiday Blues

Tips for Managing the Holiday Blues

“Children laughing, people passing, meeting smile after smile” stirs happy memories of singing Christmas carols for some, but for others, the holidays can be the most stressful and loneliest time of the year.  The holidays often present a dizzying array of demands – shopping, baking, and entertaining to name a few.  For those dealing with mental health conditions like depression or or anxiety, the holidays can be even harder.

Holiday depression can be misinterpreted as being nothing more than the winter blues.  So, when it comes to the holidays, people are more focused on their physical health issues instead of their mental health issues. They are more interested in losing weight than taking care of their mental health.  Being unaware that there is a problem can make holiday depression evolve into major depression.  Counseling and medication are good avenues to seek if you are living with symptoms of depression.

Here are 9 tips that you can use to help you with holiday depression:

  1. Be realistic – Holidays change just as people change. Kids grow older, people move, and new people will become a part of your life.  Focus on those connections, new traditions and remember past holidays with fondness while still enjoying the one right in front of you.
  2. Schedule Some Down-Time – Even 15-20 minutes a day to enjoy some quiet time, take a bath, listen to music or read a book can do wonders for your stress levels. Plus, it’s ok to say no: you don’t have to attend every party or family event.
  3. Don’t Isolate Yourself – Look for ways that you can enjoy social connections, even if you aren’t able to go home for the holidays. If you are feeling lonely, ask a friend to come over for a heart to heart or volunteer for something that interests you.
  4. Drink Only in Moderation – Alcohol is a depressant and can exacerbate negative feelings.
  5. Exercise Regularly – While hitting the gym can be tough when you are stressed and busy, try going for a short walk. Did you know that exercise can help relieve symptoms of depression?
  6. Focus on the Positives – Today is a gift. That is why it’s called the present! Being positive and practicing gratitude has a strong positive impact on psychological well-being. It increases self-esteem, enhances positive emotions and makes us more optimistic.
  7. Keep Expectations Manageable – Try to set realistic goals for yourself and your family. Pace yourself.  Organize your time and make a list and prioritize the important activities.
  8. Let People Close to You Know What’s Going On – Don’t try to hide your holiday depression from your friends and family. Hiding your problem can make your mental health worse.  Instead, be honest with them and let them know what you are going through and make sure you let them know that you don’t expect them to make it better.
  9. Seek Professional Help if You Need It – You may find yourself feeling persistently sad or anxious, unable to sleep, unable to face routine chores or irritable and hopeless despite your best efforts. If these feelings last for a while, talk to your doctor or a mental health professional.

Avoid beating yourself up if you are not full of the “joy of the season.”  With some planning, self-care and social connections, it’s possible to tackle depression around the holidays and still enjoy the season.  Be gentle with yourself, have realistic expectations, and don’t abandon your healthy habits just because it’s the holiday season.  By actively working to manage your mental health, you will be able to make the best of the holidays!

If you are experiencing these symptoms over a period of several weeks, you may be depressed. Talking with a mental health professional or taking a mental health screening test can help you understand how well you are coping with recent events. Seek help.

Four Misunderstood Terms in the Americans with Disabilities Act

Four Misunderstood Terms in the Americans with Disabilities Act

The Americans with Disabilities Act (ADA) applies to employers with 15 or more employees. Despite its broad coverage, there’s a lot of confusion about what the law requires and what its terms entail. A big reason for this confusion is the language of the law itself; the ADA speaks of nebulous concepts like undue hardship and reasonable accommodation. Words like undue and reasonable are by their nature open to some interpretation, which is not exactly a comfort to employers.

Fortunately, employers can feel confident in their application of the law by reviewing and understanding its most important concepts. In this article, we’re going to define and analyze the terms disabilityundue hardshipreasonable accommodation, and interactive process. These are the big four terms that serve as the foundation of your responsibilities as an employer under the ADA.

Disability

Let’s start with the term disability. Under the ADA, a person with a disability is someone who:

  • Has a physical or mental impairment that substantially limits one or more major life activities;
  • Has a record of such an impairment; or
  • Is regarded as having such an impairment.

Major life activities include caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working. A major life activity also includes the operation of a major bodily function, such as digestive, circulatory, and reproductive functions.

Although determining whether an impairment meets the definition of disability is an individualized assessment, some conditions “virtually always qualify.” For example, according to the EEOC, deafness substantially limits hearing; HIV substantially limits immune function; and bipolar disorder substantially limits brain function. Other conditions may vary from case to case in whether they substantially limit a major life activity.

It’s important to note that the definition of disability is broad. After the ADA was originally passed, the courts interpreted the definition very narrowly, and Congress responded by amending the ADA in 2008 so that more disabilities are covered. If an employee asks for an accommodation because of a physical or mental condition, it often won’t be hard for them to show that the condition substantially limits a major life activity.

Reasonable Accommodation

Employers often encounter the ADA when an applicant or employee asks for a reasonable accommodation. A reasonable accommodation is a change to the workplace or the job application process so that people with disabilities can perform the essential functions of their job, access employment benefits, or be considered for a job they’re qualified for. The intent of reasonable accommodations is to remove workplace barriers for people with disabilities—barriers that don’t prevent people without disabilities from performing the work or applying for the job. But don’t focus too much on the word reasonable; in the context of disability accommodations, reasonable means feasible or plausible.

Common types of accommodations include modifying work schedules, altering the way job duties are done, re-assigning a non-essential job duty (like asking the receptionist to stack the monthly 100-lb paper delivery in the storage room), granting additional breaks, providing accessible parking, and providing materials in alternative formats (e.g., Braille, large print). Another type of accommodation is a temporary leave of absence. Although a bit counterintuitive (because the employee isn’t working while on leave), the theory with a leave as an accommodation is that the time off will enable to employee to perform the essential functions of their job when they return.

Not every requested accommodation is required, however. For one, employers don’t have to remove an essential job function (e.g., the receptionist can still be expected to answer the phone). Employers also aren’t required to provide items for personal use, like wheelchairs or hearing aids. And, as we turn to next, an accommodation doesn’t have to be provided if it causes an undue hardship.

Undue Hardship

Under the ADA, an employer is not required to provide reasonable accommodations to employees or applicants with disabilities if doing so creates an undue hardship on the organization. The basic definition of undue hardship is an action that creates a significant difficulty or expense. Generally, this is a high standard to meet.

The cost of an accommodation could be an undue hardship on the employer, but so could an accommodation’s duration or disruption. An accommodation that would fundamentally alter the nature or operation of the business would be an undue hardship even if the cost was negligible. But if cost alone is the basis for claiming undue hardship, employers should remember that the standard is a significant expense.

Undue hardship is determined on a case-by-case basis, considering the following factors:

  • The nature and net cost of the accommodation, including the availability of tax credits and deductions, as well as outside funding;
  • The overall financial resources of the facility providing the accommodation, the number of employees at the facility, and the effect of the accommodation on expenses and resources;
  • The employer’s overall financial resources, size, number of employees, and the number, type, and location of its facilities;
  • The type of operation of the employer, including the composition, structure, and functions of the workforce, and the geographic separateness and administrative or fiscal relationship of the facility providing the accommodation; and
  • The impact of the accommodation on the operation of the facility, including the impact on the ability of other employees to perform their duties and the impact on the facility’s ability to conduct business.

An employer can’t claim undue hardship based on employee or customer fears or prejudices toward the disability. An undue hardship also can’t be based on the possibility that an accommodation could reduce employee morale.

Interactive Process

The interactive process is an ongoing conversation between the employer and employee to explore potential accommodations so that the employee can perform their essential job functions or access the benefits or privileges of their job.

Basically, the interactive process starts with brainstorming. The employee—and in some cases their medical provider—is often the best source for accommodation options. However, the employer should do some research too, for example, by searching for the disability or functional limitation on the Job Accommodation Network website.

Next, the employer chooses an accommodation from all the options. Employers should give consideration to which accommodation the employee prefers, but, at bottom, whatever accommodation they choose must be effective. If it’s not clear initially, the employer can implement an accommodation for a trial period to determine whether it’s effective. If that accommodation doesn’t work, employers should then try a different accommodation. In addition, circumstances may change over time, so the best practice is to keep an open dialogue with the employee to see if further adjustments are needed throughout the employment relationship.

By Megan LeMire

Originally posted on Mineral

Departments Issue Further Guidance Under No Surprises Act

Departments Issue Further Guidance Under No Surprises Act

On September 30, 2021, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), released an interim final rule (IFR) under the No Surprises Act (Act) to help protect health care consumers from surprise billing and excessive cost sharing. The IFR primarily explains the Act’s mandatory independent dispute resolution (IDR) process.

Background

A prior interim final rule established that, for emergency services and certain non-emergency services furnished by out-of-network (OON) providers at in-network facilities, patients will pay a cost-sharing rate similar to the in-network rate, which must be calculated based on a state All-Payer Model Agreement, specific state law, or, if neither apply, the qualifying payment amount (QPA). The QPA is generally the plan or carrier’s median contracted rate for the same or similar service in the specific geographic area.

The Act provides that the balance of the bill to be paid by the plan or carrier following patient cost sharing and any initial payment from the plan or carrier is determined between the provider (including air ambulance provider), facility, and the plan or carrier through an open negotiation period. If the parties cannot agree on a payment amount, the Act mandates a federal IDR process.

The IDR process applies only to:

  • Balance billing for emergency services; cost-sharing for emergency services must be determined on an in-network basis.
  • Patient copayments, co-insurance, or deductibles for emergency services and certain non-emergency services provided at an in-network facility; cannot be higher than if such services were provided by an in-network provider, and any cost-sharing obligation must be based on in-network provider rates.
  • OON charges for items or services provided by an OON provider at an in-network facility; prohibited unless notice and consent given in advance. Providers and facilities must provide patients with a plain-language consumer notice explaining that patient consent is required to receive care on an OON basis before that provider can bill the patient more than in-network cost-sharing rates.

Independent Dispute Resolution

Before initiating the IDR process, disputing parties must initiate a 30-day open negotiation period. If open negotiation fails, either party may start the IDR process. If the parties cannot agree on a jointly selected certified IDR entity, or if the jointly selected certified IDR entity has a conflict of interest, the Departments will select a certified IDR entity. The parties will submit their payment offers along with supporting documentation, and the certified IDR entity will issue a binding determination by selecting one party’s offer.

When making a payment determination, certified IDR entities must assume that the QPA is the appropriate OON amount. The certified IDR entity must consider any credible permissible information submitted by a party. For the IDR entity to deviate from the offer closest to the QPA, however, any information submitted must clearly demonstrate that the value of the item or service is materially different from the QPA.

The IDR process will proceed according to the following guidelines:

Expanded External Review

Additionally, the IFR expands the scope of adverse benefit determinations eligible for external review to include determinations that involve whether a plan or issuer is complying with the surprise billing and cost-sharing protections under the No Surprises Act and its implementing regulations. In addition, under these interim final rules, grandfathered plans that are not otherwise subject to external review requirements will be subject to external review requirements for coverage decisions that involve whether a plan or issuer is complying with the surprise billing and cost-sharing protections under the No Surprises Act.

Conclusion

The regulations in the IFR become applicable to group health plans for plan and policy years beginning on or after January 1, 2022. However, the IFR is subject to a public comment period that will close in December 2021. We will continue to monitor this and other related developments under the No Surprises Act and provide ongoing updates as needed.

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