California Employment Law Update – October 2018

California Employment Law Update – October 2018

Criminal History and Job Applicants

On September 30, 2018, California Governor Jerry Brown signed legislation (S.B. 1412) specifying that employers, public agencies, private individuals, and corporations (employer) may:

  • Ask employees or applicants about an arrest when they are out on bail or on their own recognizance pending trial.
  • When complying with state, federal, or local law:
    • Conduct criminal background checks for employment purposes.
    • Restrict employment based on criminal history.
    • Seek or receive an applicant’s criminal history report when obtained pursuant to procedures otherwise provided under applicable law.

Additionally, employers may ask an applicant about, or seek from any source, information regarding a particular conviction if any of the following apply (per 12 U.S.C. § 1829, other federal law, federal regulation, or state law):

  • Regardless of whether a particular conviction was expunged, judicially ordered sealed, statutorily eradicated, or judicially dismissed following probation:
    • The employer is legally required to obtain information about it;
    • An individual with that particular conviction is legally prohibited from holding the position sought; or
    • The employer is legally prohibited from hiring an individual who has that particular conviction.
  • The applicant would be required to possess or use a firearm in the course of employment.

The law also newly defines the following:

  • A particular conviction is a conviction for specific criminal conduct or a category of criminal offenses prescribed by any federal law, federal regulation, or state law that contains requirements, exclusions, or both, expressly based on that specific criminal conduct or category of criminal offenses.
  • A conviction is a plea, verdict, finding of guilt, regardless of whether a sentence is imposed by the court. However, any adjudication by a juvenile court or any other court order or action taken with respect to a person who is under the process and jurisdiction of the juvenile court continues to be protected.

The law is effective January 1, 2019.
Read CA S.B. 1412

FEHA, Harassment, Training, and Nondisparagement Agreements

On September 30, 2018, California Governor Jerry Brown signed legislation (S.B. 1300) amending the California Fair Employment and Housing Act (FEHA) as follows:

  • By removing the word “sexual” from the protections against harassment and thereby making employers responsible for the acts of nonemployees with respect to all harassment of employees, applicants, unpaid interns or volunteers, or persons providing services pursuant to a contract in the workplace, if the employer, or its agents or supervisors, knows or should have known of the conduct and fails to take immediate and appropriate corrective action.
  • An employee of an entity subject to the FEHA who is alleged to have engaged in any prohibited harassment may be held personally liable for any act in violation of the law.
  • Employers are authorized to provide bystander intervention training that includes information and practical guidance on how to enable bystanders to recognize potentially problematic behaviors and to motivate bystanders to act when they observe problematic behaviors. The training and education may include exercises to provide bystanders with the skills and confidence to intervene as appropriate and to provide bystanders with resources they can call upon that support their intervention.
  • In exchange for a raise or bonus, or as a condition of employment of continued employment, employers are prohibited from requiring the execution of a release of a claim or right under the FEHA or from requiring an employee to sign a nondisparagement agreement or other document that purports to deny the employee the right to disclose information about unlawful acts in the workplace, including, but not limited to, sexual harassment. An agreement or document in violation of either of those prohibitions is contrary to public policy and unenforceable.

The law is effective January 1, 2019.
Read CA S.B. 1300

Home Care Aide Registry and Disclosure of Personal Information

On September 30, 2018, California Governor Jerry Brown signed legislation (A.B. 2455) requiring, for any new registration or renewal of registration of a home care aide occurring on and after July 1, 2019, the State Department of Social Services to provide, upon request, a labor organization an electronic copy of a registered home care aide’s name, telephone number, and cellular telephone number. The department must also establish a simple opt-out procedure that would allow a home care aide to prohibit it from sharing his or her information and would require the department, at the time of registration or renewal of registration, to inform a home care aide how to use the simple opt-out procedure.
The law also prohibits labor organizations from using or disclosing the shared information, with exception.
The law is effective January 1, 2019.
Read CA A.B. 2455

Lactation Accommodation in the Workplace

On September 30, 2018, California Governor Jerry Brown signed legislation (A.B. 1976) specifying that an employer who makes a temporary lactation location available to an employee is in compliance with the state’s workplace lactation accommodation requirements if all of the following conditions are met:

  • The employer is unable to provide a permanent lactation location because of operational, financial, or space limitations.
  • The temporary lactation location is private and free from intrusion while an employee expresses milk.
  • The temporary lactation location is used only for lactation purposes while an employee expresses milk.
  • The temporary lactation location otherwise meets the requirements of state law concerning lactation accommodation.

An agricultural employer, is in compliance with the law if it provides an employee wanting to express milk with a private, enclosed, and shaded space, including, but not limited to, an air-conditioned cab of a truck or tractor.
Additionally, if an employer can demonstrate to the California Department of Labor that the requirement to provide the employee with the use of a room or other location, other than a bathroom would impose an undue hardship when considered in relation to the size, nature, or structure of the employer’s business, then an employer must make reasonable efforts to provide an employee with the use of a room or other location, other than a toilet stall, in close proximity to the employee’s work area, for the employee to express milk in private.
The law is effective January 1, 2019.
Read CA A.B. 1976

Mandatory Placement of Women on Board of Directors

On September 30, 2018, California Governor Jerry Brown signed legislation (S.B. 826) requiring all of the following:

  • By no later than the close of the 2019 calendar year, a publicly held domestic or foreign corporations (corporation) whose principal executive offices (per its SEC 10-K form) are located in California must have at least one female on its board of directors.
  • By no later than the close of the 2021 calendar year, corporations must comply with the following, as applicable:
    • If its number of directors is six or more, then the corporation must have a minimum of three female directors.
    • If its number of directors is five, then the corporation must have a minimum of two female directors.
    • If its number of directors is four or fewer, then the corporation must have a minimum of one female director.

According to the law, a female is an individual who self-identifies her gender as a woman, without regard to the individual’s designated sex at birth. The California Secretary of State will impose the following fines for violations:

  • $100,000 for failure to timely file board member information with the Secretary of State.
  • $100,000 for a first violation.
  • $300,000 for a second or subsequent violation.
  • Each director seat required to be held by a female, which is not held by a female during at least a portion of a calendar year, is a violation. However, a female director having held a seat for at least a portion of the year is not a violation.

The law is effective January 1, 2019.
Read CA S.B. 826

Settlement Agreements and Confidentiality

On September 30, 2018, California Governor Jerry Brown signed legislation (S.B. 820) prohibiting a provision in a settlement agreement that prevents the disclosure of factual information relating to any of the following claims that are filed in a civil or administrative action:

  • Sexual assault.
  • Sexual harassment.
  • Workplace harassment or discrimination based on sex.
  • Retaliation for reporting harassment or discrimination based on sex.

However, a provision that shields the identity of the claimant and all facts that could lead to the discovery of his or her identity, including pleadings filed in court, may be included within a settlement agreement at the claimant’s request. This does not apply if a government agency or public official is a party to the settlement agreement.
Under the law, any provision within a settlement agreement that prevents the disclosure of factual information related to the claim entered into on or after January 1, 2019, is void as a matter of law and against public policy.
The law is effective January 1, 2019.
Read CA S.B. 820

Sexual Harassment and Waiver of Right of Petition or Free Speech in Contracts

On September 30, 2018, California Governor Jerry Brown signed legislation (A.B. 3109) making a provision in a contract or settlement agreement void and unenforceable if it waives a party’s right to testify in an administrative, legislative, or judicial proceeding concerning alleged criminal conduct or sexual harassment.
The law is effective January 1, 2019.
Read CA A.B. 3109

Sexual Harassment Training Modifications

On September 30, 2018, California Governor Jerry Brown signed legislation (S.B. 1343) modifying the California Fair Employment and Housing Act (FEHA) sexual harassment training requirements as follows:

  • By January 1, 2020, an employer with five or more employees (rather than 50 or more) must provide at least two hours of classroom or other effective interactive training and education regarding sexual harassment to all supervisory employees and at least one hour of classroom or other effective interactive training and education regarding sexual harassment to all nonsupervisory employees in California within six months of hire. The law provides the following additional provisions:
    • Employers may provide this training in conjunction with other training provided to employees.
    • The training may be completed by employees individually or as part of a group presentation, and may be completed in shorter segments, as long as the applicable hourly total requirement is met.
    • An employer who has provided this training and education to an employee after January 1, 2019, is not required to provide training and education by the January 1, 2020, deadline.

After January 1, 2020, each covered employer must provide sexual harassment training and education to each employee in California once every two years.

  • Beginning January 1, 2020, for seasonal and temporary employees, or any employee that is hired to work for less than six months, an employer must provide training within 30 calendar days after the hire date or within 100 hours worked, whichever occurs first. For temporary employees who are employed by a temporary services employer, to perform services for clients, the training must be provided by the temporary services employer, not the client.
  • Beginning January 1, 2020, sexual harassment prevention training for migrant and seasonal agricultural workers must be consistent with training for nonsupervisory employees.

Employers may develop their own training module or use the California Department of Fair Employment and Housing’s training which it will develop and post on its website. The department will also make existing informational posters, fact sheets, as well as the online training courses regarding sexual harassment prevention available online and in alternate languages.
The law is effective January 1, 2019.
Read CA S.B. 1343

Talent Agencies and Sexual Harassment

On September 30, 2018, California Governor Jerry Brown signed legislation (A.B. 2338) requiring the following:

  • A talent agency must provide educational materials on sexual harassment prevention, retaliation, and reporting resources and nutrition and eating disorders to its artists. These educational materials must be in a language the artist understands, and would require the licensee, as part of the application for license renewal, to confirm with the California Labor Commissioner that it has and will continue to provide the relevant educational materials.
  • Prior to issuing a permit to employ a minor in the entertainment industry, an age-eligible minor and the minor’s parent or legal guardian must receive and complete training in sexual harassment prevention, retaliation, and reporting resources. A talent agency must also request and retain a copy of the minor’s entertainment work permit prior to representing or sending a minor artist on an audition, meeting, or interview for engagement of the minor’s services.

The law also makes it a violation of existing laws for a talent agency to fail to comply with the education and permit retention requirements and authorizes the commissioner to assess civil penalties of $100 for each violation.
The law is effective January 1, 2019.
Read CA A.B. 2338

Information Privacy and Connected Devices

On September 28, 2018, California Governor Jerry Brown signed legislation (S.B. 327) requiring manufacturers of a connected device to equip it with a reasonable security feature that is appropriate to the nature and function of the device, appropriate to the information it may collect, contain, or transmit, and designed to protect the device and any information it contains from unauthorized access, destruction, use, modification, or disclosure.
Under the law, a connected device is any device, or other physical object that is capable of connecting to the Internet, directly or indirectly, and that is assigned an Internet Protocol address or Bluetooth address. Additionally, a manufacturer is the person who manufactures, or contracts with another person to manufacture on their behalf, connected devices that are sold or offered for sale in California. A contract with another person to manufacture on their does not include a contract only to purchase a connected device, or only to purchase and brand a connected device.
The law is effective January 1, 2020.
Read CA S.B 327

Personal Information

On September 28, 2018, California Governor Jerry Brown signed legislation (S.B. 244) implementing additional privacy protections for an individual’s personal information. The law requires that information or documents obtained by a California city, county, or other local agency for local identification card issuance may only be used to administer the ID card program or policy. It may not be used to for discriminatory purposes, be otherwise disclosed except in response to a subpoena for individual records, is exempted from disclosure and is not public record under the California Public Records Act.
Moreover, the law provides the following protections:

  • Documents provided by applicants to prove identity or residency may not be disclosed except in response to a subpoena for individual records in a criminal proceeding or pursuant to a court order, or in response to a law enforcement request to address an urgent health or safety need.
  • The use of a driver’s license issued under these provisions is prohibited to be used evidence of an individual’s citizenship or immigration status for any purpose.
  • Where a drivers’ license states, “This card is not acceptable for official federal purposes. This license is issued only as a license to drive a motor vehicle. It does not establish eligibility for employment, voter registration, or public benefits,” all of the following are violations:
    • To discriminate based on this type of license.
    • Under the Unruh Civil Rights Act, for a business establishment to discriminate against a person because he or she holds or presents this type of license.
    • Under the California Fair Employment and Housing Act, for an employer or other covered person or entity (employer) to discriminate against a person because he or she holds or presents this type of license, or for an employer to require a person to present a driver’s license, unless possessing a driver’s license is required by law or by the employer and is permitted by law. However, this protection does not limit or expand an employer’s authority to require a person to possess a driver’s license.

The law does not alter an employer’s federal rights or obligations regarding obtaining documentation evidencing identity and authorization for employment. Any action taken by an employer that are required by the federal Immigration and Nationality Act are not violations.
The law is effective January 1, 2019.
Read CA S.B. 244

CCPA Amended

On September 23, 2018, California Governor Jerry Brown signed legislation (S.B. 1121) amending the state’s Consumer Privacy Act of 2018 (CCPA) as follows:

  • It retained the CCPA’s operative date of January 1, 2020 but made the act immediately effective. According to the bill, the need for the immediate effective date is to prevent confusion that could be created if local laws regarding the collection and sale of personal information were enacted prior to January 1, 2020 and were in conflict with the CCPA.
  • The Attorney General is required to draft the CCPA’s implementing regulations. However, S.B. 1121 provides these regulations are not required to be in place until July 2, 2020. Moreover, under the bill, the AG may not bring an action to enforce the law until six months after the final regulations are published or July 1, 2020, whichever is earlier.
  • Adding more exceptions to the CCPA application, for example, some clinical trials and Confidentiality of Medical Information Act covered healthcare providers (but not under all circumstances).
  • Clarifying that the only private right of action permitted under the act is the private right of action for violations of unauthorized access and exfiltration, theft, or disclosure of a consumer’s nonencrypted or nonredacted personal information and deleting the requirement that a consumer bringing a private right of action notify the Attorney General.
  • Limiting the civil penalty levied by the Attorney General to not more than $2,500 per violation and not more than $7,500 per each intentional violation, and provides an injunction as another available remedy.

The law is effective September 23, 2018.
Read CA S.B. 1121

Petroleum Facilities, Rest Breaks, and Safety Positions

On September 20, 2018, California Governor Jerry Brown signed legislation (A.B. 2605) exempting employees who hold safety-sensitive positions (those where duties reasonably include responding to emergencies in the facility and carrying communication devices) at a petroleum facility from the rest and recovery period requirements. The exemption only applies to employees who are subject to California Industrial Welfare Commission Order No. 1 and are covered by a collective-bargaining agreement. However, for any rest or recovery period during which an employee was interrupted, or forced to miss, the employer is required to pay one additional hour of compensation to the employee at his or her regular rate of pay.
The law became effective September 20, 2018, remains in effect until January 1, 2021, and then is repealed.
Read CA A.B. 2605

Occupational Injury and Illness and Recordkeeping Violations

On September 19, 2018, California Governor Jerry Brown signed legislation (A.B. 2334) regarding workplace injury and illnesses and reporting standards. Under the act, Cal/OSHA law at Cal. Labor Code § 6317 newly defines what a violation occurrence is, as related to the statute of limitations in a Cal/OSHA recordkeeping violation. Specifically, under the law an occurrence continues until it is corrected, or until the California Division of Occupational Safety and Health (division) discovers the violation, or until the duty to comply with recordkeeping requirement no longer exists. Thus, the Cal/OSHA enforcement branch may issue a citation for a recordkeeping violation which occurred any time during the Cal/OSHA five-year recordkeeping period because this new law defines a violation occurrence as continuing until it is corrected. Additionally, the law revised the Cal. Labor Code § 6317 language to state that a citation or notice will not be issued by the division more than six months after the occurrence of the violation. Prior to the bill, the entirety of § 6317 merely stated that, “no citation or notice will be issued by the division for a given violation or violations after six months have elapsed since occurrence of the violation.”
The law is effective January 1, 2019.
Read CA A.B. 2334
Originally posted on thinkhr.com

Addressing Mental Health Care at Work

Addressing Mental Health Care at Work

Nancy Spangler, senior consultant at the Center for Workplace Mental Health of the American Psychiatric Foundation, says that one in five adults has a mental health disorder, and one in 10 has a substance abuse problem. In addition, major depression and its associated conditions cost the U.S. over $210 billion every year. Clearly, mental health is an issue we need to investigate both in our offices and across the country.
Many organizations have found that simply by working with employees to recognize depression, build empathy, and find resources, increased EAP utilization while claim dollars did the opposite. In most cases there was no formal program involved—leadership simply began talking about the issue, and the reduced stigma led to better health (and better offices!).
What can we do besides reducing stigma, especially from the top down?At the 2018 Health Benefits and Leadership Conference, experts listed five “buckets” of challenges in addressing mental health: access to care, cost of care, stigma, quality, and integration. Breaking these down into individual components not only helps employees find the support they need and deserve, but it further reduces stigma by refusing to separate mental health from medical coverage or wellness programs. Experts also recommend inviting EAPs to visit offices in person, instead of simply suggesting employees call when they can. Another increasingly popular technique is text-based therapy. This a great fit for many employees because someone is always available and the conversation is always private, even when the client is sitting at a desk in a shared space.
In addition to reducing stigma through transparency and access, employers can also help increase the quality of care available to employees. One key move is simply asking for data. How do vendors evaluate quality, meet standards, and screen for illness? Do health plan members have confidential ways to report their experiences? Mental health care should be seen no differently from other kinds of health care. Employees who have access to quality, destigmatized mental health care build stronger, more functional, and ever-happier workplaces.

By Bill Olson
Originally posted on UBAbenefits.com

SCOTUS 2018 Roundup and 2019 Preview

SCOTUS 2018 Roundup and 2019 Preview

The Supreme Court of the United States (SCOTUS) heard several cases with employment implications during their 2018 session, including the following four cases we covered in detail. (Click the case names to read the full articles.)

  • Encino Motorcars, LLC v. Navarro: Encino shifted the burden of proof in Fair Labor Standards Act (FLSA) overtime exemption cases to the plaintiff, meaning that if employees cannot prove they were misclassified, they will not be entitled to overtime pay.
  • Epic Systems Corp. v. Lewis: Epic held that employers may enforce class action waivers in arbitration agreements rather than being obligated to allow employees to unite in a class action suit.
  • Masterpiece Cakeshop, Ltd. V. Colorado Civil Rights Commission: Masterpiece argued the key civil rights issues of discrimination versus freedom of religion. Although both sides declared a win, the court simply decided that the law is the law and employers cannot deny equal access to goods and services but also religion remains a highly-protected civil right.
  • Janus v. American Federation of State, County, and Municipal Employees: Janus ruled that public sector employees are not required to pay fees to a union they choose not to join, even if they receive the benefits of the union’s negotiations.

Notable cases that SCOTUS declined to hear in 2018 touched on tip pooling, Americans with Disabilities (ADA) leave, age discrimination, sexual discrimination, and compensation during rest breaks.
The overall trend in the 2018 rulings was a tendency to favor employers. This conservative lean of the court was also reflected in its ruling in Trump v. Hawaii, where the court held the president lawfully exercised the broad discretion granted to him under federal law to suspend the entry of people from certain countries into the United States.

What’s Coming Up?

With Brett Kavanaugh’s potential confirmation as the new SCOTUS justice due to Justice Kennedy’s retirement, SCOTUS will likely continue on the conservative trend. The EEOC is speculating that cases potentially on the docket for the Supreme Court next season may be related to age discrimination, equal pay, sexual orientation, and gender identity, including possible appeals of these circuit court decisions:

  • Rizo v. Yovino: The Ninth Circuit Court of Appeals held that under the federal Equal Pay Act an employer cannot justify a wage differential between male and female employees by relying on prior salary.
  • EEOC v. R.G. & G.R. Harris Funeral Homes: The Sixth Circuit Court of Appeals ruled that employers may not discriminate against employees because of failure to conform to sex stereotypes, transgender, or transitioning status.
  • Kleber v. CareFusion Corporation: The Seventh Circuit Court of Appeals found that an outside job applicant can assert a disparate impact claim under the federal Age Discrimination in Employment Act. (Disparate impact refers to employment practices that appear to be nondiscriminatory but adversely affect one group of protected class individuals more than others.)
  • Zarda v. Altitude Express, Inc.: The Second Circuit Court of Appeals ruled that Title VII protects employees from discrimination based on sexual orientation.

Other cases being considered include the applicability of the Age Discrimination in Employment Act (ADEA) to small public employers, whether the Federal Arbitration Act applies to independent contractors, and whether payment to an employee for time lost from work is compensation subject to employment taxes.
Originally posted on thinkhr.com

Affordable Care Act Update

Affordable Care Act Update

Recently, the President signed a bill repealing the Affordable Care Act’s Individual Mandate (the tax penalty imposed on individuals who are not enrolled in health insurance). While some are praising this action, there are others who are concerned with its aftermath. So how does this affect you and why should you pay attention to this change?
First, as an individual, if you do not carry health insurance, you are currently paying a penalty of $695/adult not covered and $347.50/uninsured child with penalties going even as high as $2085/household. These penalties have been the deciding factor for most uninsured Americans—go broke buying insurance but they have insurance, or go broke paying a fine and still be uninsured. With the repeal signed in December 2017, these penalties are zeroed out starting January 1, 2019.  While it seems that the repeal of the tax penalty should be good news all around, it does have some ramifications. Without reform in the healthcare arena for balanced pricing, when individuals make a mass exodus in 2019, we can expect higher premiums to account for the loss of insured customers.
As a business, you are still under the Employer Mandate of the ACA. There have been no changes to the coverage guidelines and reporting requirements of this Act. However, with healthy people opt-ing out of health insurance coverage, the employer premiums can expect to be raised to cover the increased expenses of the sick. Some do predict the possibility of the repeal of some parts of the Employer Mandate —specifically PCORI fees and employment reporting. The Individual and Employer Mandates were created to compliment each other and so changes to one tend to mean changes to the other.
So, why should you pay attention to this change? Because the balance the ACA Individual Mandate was designed to help make in the health insurance marketplace is now unbalanced. Taking one item from the scale results in instability. Both employers and employees will be affected by this tax repeal in one way or another.

The News about Association Health Plans

The News about Association Health Plans

On June 19, 2018, the U.S. Department of Labor released its Final Rule regarding Association Health Plans (AHPs). AHPs are not new, but they have not been widely available in the past and, in some cases, they have not been successful. The Final Rule is designed to make AHPs available to a greater number of small businesses as an alternative to standard ACA-compliant small group insurance policies.

This article answers common questions about AHPs under the current rules (which groups can continue to use) and the new rules.

Is group medical insurance the same for small and large employers?

Yes and no. Federal law imposes certain basic requirements on all group medical plans, regardless of the employer’s size. For instance, plans cannot exclude pre-existing conditions nor impose annual or lifetime dollar limits on basic benefits. If the plan is insured, it also is subject to the insurance laws of the state in which the policy is issued.
Small group policies, which are sold to employers with up to 50 or 100 employees, depending on the state, are subject to additional requirements. These policies must cover 10 categories of essential health benefits (EHBs), including hospitalization, maternity care, mental health and substance abuse treatment, and prescription drugs. (Some states allow certain grandfathered or grandmothered policy exceptions.) For most small employers, their options for group medical insurance are limited to small group policies that comply with the full scope of ACA requirements. On the other hand, the policies are subject to guaranteed issue and adjusted community rating rules, so carriers cannot refuse to insure a small employer nor use any past claims experience in setting rates.
Large group policies, which can only be sold to groups with at least 50 or 100 employees, depending on the state, are not required to cover all EHBs. Carriers have more flexibility in designing coverage options and developing premium rates in the large group market. This means larger employers have more options to choose from and may be able to purchase coverage at a lower cost than would apply to a small group policy. Note, however, that there is no guaranteed issue protection, so carriers can accept or reject each employer’s application or use the employer’s past claims experience in setting rates.
Lastly, self-funded plans are subject to the ACA and other federal laws, but generally are exempt from state laws. They typically are not feasible for small employers, however, due to the financial risk of uninsured programs.

What is an Association Health Plan (AHP)?

Group insurance covers the employees of an employer (or an employee organization such as a labor union). An AHP, as the name implies, covers the members of an association. Unrelated employers can obtain coverage for their employees through an AHP provided the employers form a bona fide association. Traditionally, this has meant that the employers had to have a “commonality of interest” and their primary interest had to be something other than an interest in providing benefits. For this reason, AHPs generally have been limited to associations formed by employers in the same trade, industry, or profession.
The Final Rule makes AHPs available to a wider range of businesses by expanding the meaning of “commonality of interest.” Once the Final Rule takes effect, an association may be formed by employers that are:

  • In the same trade, industry, or profession, regardless of location; or
  • In the same principal place of business; i.e., in the same state or in the same multi-state metropolitan area.

Under the new rules, the employer’s primary interest in associating may be benefits coverage, although they still will need to have at least one other substantial business purpose other than benefits. This is a key difference from the current rules.

When does the new Final Rule take effect?

The Final Rule expanding the definition of an association for purposes of an AHP will take effect on staggered dates:

  • For fully insured AHPs: September 1, 2018
  • For self-funded AHPs:
    • If in existence on or before June 19, 2018: January 1, 2019
    • If created after June 19, 2018: April 1, 2019

As noted, the new rules do not replace existing rules. Employers and associations may continue to follow the existing rules (which generally limit AHPs to employers in the same trade, industry, or profession). The new rules merely expand the opportunities for AHPs, such as making them available to employers in the same state or metropolitan area even if they are in different industries.

Are AHPs limited to employers with employees? What about sole proprietors?

Currently, sole proprietors, such as mom-and-pop shops without any W-2 employees, purchase medical insurance in the individual market. Individual policies often cost more than group policies or AHPs. The new rules will expand the availability of AHPs to include sole proprietors who work a minimum number of hours (so-called working owners).

What about state laws? Will AHPs be available nationwide?

Insurance products, including AHPs, are regulated by state law. Under both the existing and new rules, AHPs are multiple employer welfare arrangements (MEWAs). State laws on MEWAs are quite complicated. In some states, MEWAs are prohibited. In others, insured MEWAs are allowed but self-funded plans are prohibited. The laws vary from state to state, so different carriers will make different decisions about whether they want to design and market AHPs in various jurisdictions around the country.
A number of states are very concerned about AHPs and may prohibit them in their states or impose strict requirements to ensure they will provide reliable and effective coverage. Other states will view AHPs as cost-effective alternatives to ACA-compliant policies for small employers and look to encourage their expansion.

What’s next?

There is no clear answer to what’s next. Over the coming months, carriers across the country likely will review the reasons they have or have not offered AHPs in the past, and whether they want to consider new approaches in the future. Along with economic and market issues to consider, carriers also must consider the state insurance laws in different jurisdictions. At the same time, many state legislatures and insurance commissioners will be reviewing their existing rules and whether they want to promote or expand the availability of AHPs in their area.
Oh … and the lawsuits. Yes, that also is what’s next. As of this writing, attorneys general in different states are planning to join together in challenging the federal government’s Final Rule on AHPs. Their stated concern is that effective regulation is required to ensure that plans provide adequate coverage.
ThinkHR will continue to monitor developments in this area.
by Kathleen A. Berger
Originally posted on thinkhr.com