Scirocco Insurance Blog - Scirocco Group

ACA Updates from Scirocco Group

Delayed Reporting for 2015 Information Under IRC 6055 and 6056

IRS Notice 2016-4 extends due dates for both furnishing to individuals and filing with the IRS for insurers, employers, and other providers of Minimum Essential Coverage (MEC) and information reporting by Applicable Large Employers (ALEs).

  • – There is an automatic extension for furnishing Forms 1095-B and 1095-C to individuals from February 1, 2016 to March 31, 2016.
  • – If not filing electronically, there is an automatic delay for Forms 1094-B, 1095-B, 1094-C, and 1095-C from February 29, 2016 toMay 31, 2016.
  • – There is an automatic extension to file electronically for Forms 1094-B, 1095-B, 1094-C, and 1095-C with the IRS from March 31, 2016 toJune 30, 2016.

The notice also provides guidance to individuals who might not receive Forms B or C by the time they file their 2015 tax returns.

REMINDER: Employers who have 50 or more full-time employees including equivalents are considered ALEs. All ALEs are subject to Employer Reporting of 2015 information even if they qualified for Transitional Relief of the Employer Shared Responsibility / Play or Pay for 2015.

Self-insured employers that are not ALEs are subject to Form B reporting.

For further details regarding reporting, see our contact a Scirocco Group representative.

ACA Guidance: Two-Year Delay of the Cadillac Tax

President Obama signed federal legislation on December 18, 2015, which delays the Cadillac tax for two years.

In addition to delaying the Cadillac tax, the legislation provides the following:

  • – a two-year delay of the excise tax (aka the Cadillac tax) on high-cost plans (therefore, this will not be applicable in 2018 and 2019)
  • – a one year delay of the Health Insurance Tax (HIT will be applicable on 2017 premium)
  • – a suspension of the medical devices tax until December 31, 2017

For more details on federal health care reform, including information on taxes and provisions, visit www.sciroccogroup.com.

If you have any questions, contact your Scirocco Account Executive.

CRT December Holiday Lunch 2015

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Faulty Workmanship and E & O Reducing Exposures hosted by CRTNJ

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Hurricane Joaquin Tips for your Business


        Loss of power or phones will not affect our ability to meet your insurance needs.

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Hurricane Joaquin is forecast to track up the East Coast over the next few days. There is still much uncertainty of the storms path at this point. However, we wanted to reach out to our friends and clients to provide some tips to help you prepare your business against the storm.

     • Backup all data on servers and personal computers.

     • Turn off all non-critical devices such as server monitors and workstations
     and other non-essential electrical equipment prior to the storm’s arrival.

     • Check/maintain all necessary backup equipment, such as emergency generators
     and communication devices.

     • Relocate vital records, equipment, tools, stored materials, and other business
     property from low lying areas, especially basements or flood prone low lying areas.

     • Raise property in areas that could flood off the ground level at least 4’ if it
     cannot be moved to a different location or floor.

     • Take the following steps so that items outdoors will not blow away or cause
     damage:

          ◦ Remove all loose debris

          ◦Anchor or relocate all nonessential equipment to a safe indoor location

          ◦Secure storage of flammable liquid drums, or move them to a sheltered area
          (but never into main facility areas)

          ◦Anchor all portable buildings (e.g., trailers) to the ground

          ◦Secure large cranes and other heavy equipment

          ◦Make sure outdoor signs are properly braced

          ◦Ensure that the employees who volunteer to stay on site have proper supplies
          and equipment (drinkable water, nonperishable food, medical,
          flashlights, extra gasoline, walkie-talkies).

     • Fill fuel tanks of generators, fire pumps, and all company-owned vehicles.

     • Move all vehicles and movable equipment to a safe, high lying area.

     • Clean out drains and catch basins.

Your safety and well-being are our main concern and we are here to assist you in any way possible.

If you require access to your policies, claims, or certificates, please log in to your Scirocco 24/7 account. There will be someone accesible by telephone throughout the storm, and after, to provide answers for your questions, receive claims, and adopt policy changes on your behalf. They are prepared to stay on the line with you until you are satised with your service. Log In Here

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If you prefer to contact us by phone, please visit our contact page for important phone numbers to utilize during the storm.

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Hurricane Joaquin Tips for at Home


        Loss of power or phones will not affect our ability to meet your insurance needs.

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Hurricane Joaquin is forecast to track up the East Coast over the next few days. There is still much uncertainty of the storms path at this point. However, we wanted to reach out to our friends and clients to provide some tips to help you prepare your home and family against the storm.

Before the Storm Hits:

     • Cover windows and doors and secure outdoor furniture.

     • Make sure you have three gallons of water per family member.

     • Refill your prescriptions, fill up your car with gas and withdraw a week’s
     worth of cash since power outages may interrupt these services temporarily.

     • Place important, valuable papers such as your log of possessions in
     waterproof bags.

     • If you live in a trailer home and are told to evacuate, do so immediately.


During the Storm:

     • You should have canned food for at least three days and a can opener.

     • Listen to your battery-operated radio for instructions from the local authorities on
     evacuation and safety guidelines.

     • Seek shelter in an interior room away from windows, such as a closet. If you hear
     the winds subside, do not assume that the storm is over. The calm
     may be the eye of the storm, in which case the worst is yet to come.

     • If the electricity goes out, use a flashlight to see; do not use candles.

After the Storm:


     • Make sure you have pet food and supplies for three days.

     • When inspecting your home for damage, wear sturdy shoes and clothing
     as protection.

     • Contact a trained expert to turn off damaged utilities and appliances instead
     of trying to do it yourself.

     • Drink only bottled water until tap water is deemed safe.

Your safety and well-being are our main concern and we are here to assist you in any way possible.

If you require access to your policies, claims, or certificates, please log in to your Scirocco 24/7 account. There will be someone accesible by telephone throughout the storm, and after, to provide answers for your questions, receive claims, and adopt policy changes on your behalf. They are prepared to stay on the line with you until you are satised with your service. Log In Here

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If you prefer to contact us by phone, please visit our contact page for important phone numbers to utilize during the storm.

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Scirocco Group Included In IIABA’s Best Practices Study

FOR IMMEDIATE RELEASE

 

Scirocco Group Included In IIABA’s

Best Practices Study

 

Hasbrouck Heights, NJ, 09/23/2015 – Scirocco Group continues for the 8th year in a row to be part of an elite group of independent insurance agencies around the United States participating in the Independent Insurance Agents & Brokers of America (IIABA or the Big “I”) “Best Practices” Study Group.

The agencies comprising the study group are selected every third year through a comprehensive nomination and qualifying process and awarded a “Best Practices Agency” designation. The selected “Best Practices” agencies retain their status during the three-year cycle by submitting extensive financial and operational data for review each year. Only 196 independent agencies throughout the U.S. retained their status for 2015.

The Best Practices Study was initiated by IIABA in 1993 as the foundation for efforts to improve agency performance. The annual study of leading independent insurance agencies, which is conducted for IIABA by Reagan Consulting of Atlanta, Ga., documents the business practices of these “best” agencies and urges others to adopt similar practices.

To assist agencies in adopting Best Practices, IIABA has developed a family of products, service and workshops known as the Best Practices Implementation Series. The series includes materials such as the Agency Self-Diagnostic Tool, Agency/Company Joint Planning Tool Quick Step, and Top Producers: Discover, Train, Reward. Additional studies and tools are added periodically. The publications include guidelines, worksheets, and case studies to help agents apply the information contained in each report.

In addition to the written materials, hundreds of workshops and seminars have been conducted at various producer association functions, company sponsored agency meetings and national automation users group conventions.

The IIABA and Reagan Consulting jointly maintain the Best Practices Gateway website (http://bp.reaganconsulting.com) that provides executive summaries of the annual Best Practices Studies, the Best Practices Quick Check interactive comparison tool and samples from the various Best Practices tools. The Gateway, as well as the annual study, is made possible in part through the financial sponsorship of various insurance companies and industry organizations.

The 2015 Best Practices Study sponsors include: Agency Business Solutions and Amerisure Insurance, Applied Systems, Beyond Insurance, Central Insurance Companies, Chubb, CNA, EMC Insurance Companies, ENCOMPASS Insurance, Erie Insurance, The Hanover Insurance Group, Nationwide, Imperial PFS, InsurBanc, Kemper Preferred, Liberty Mutual, The Main Street America Group, MetLife Auto & Home, Travelers, Vertafore and Westfield Insurance.

For more information on the Best Practices Study, contact Jennifer Becker at IIABA, 1-800-221-7917.

Founded in 1896, IIABA is the nation’s oldest and largest national association of independent insurance agents and brokers, representing a network of more than 300,000 agents, brokers and their employees nationally. Its members are businesses that offer customers a choice of policies from a variety of insurance companies. Independent agents and brokers offer all lines of insurance – property, casualty, life and health—as well as employee benefit plans and retirement precuts. Web address: www.independentagent.com.

 

ACA Contraceptive Coverage Accommodations for Religious Organizations


        Final Rule Issued on ACA Contraceptive Coverage Exemptions

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Churches and other houses of worship are exempt from the ACA’s requirement to cover contraceptives. Other church-affiliated institutions that object to providing contraceptive coverage on religious grounds, such as schools, charities, hospitals and universities, can be eligible for an accommodations approach.

Under these accommodations, eligible organizations are not directly involved with providing any contraceptive coverage to which they object on religious grounds. Payments for these contraceptive services will be provided by an independent third party, such as an insurance company or third-party administrator (TPA), directly and free of charge.

To be eligible for the accommodation, an organization or employer must meet specific requirements and was required to self-certify that it met the criteria (HHS has provided a self-certification form for this purpose).

A number of organizations challenged the self-certification requirement, arguing that it infringes on religious liberty because it makes the nonprofit organization complicit in the provision of birth control.

In response to these challenges, the Departments previously provided an alternative way for an eligible organization to provide notification of its objection to covering contraceptives: by notifying HHS in writing of its religious objection to providing contraceptive coverage instead of providing the self-certification to the plan’s issuer or TPA. This option has been confirmed in the final regulations.

Under the Affordable Care Act (ACA), non-grandfathered health plans must cover certain preventive health services for women, including contraceptives, without imposing cost-sharing requirements for the services.

On July 10, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) released final regulations on the ACA’s women’s preventive care coverage requirement.

These regulations:

     • Finalize an accommodation for eligible nonprofit organizations and for-
     profit businesses with religious objections to providing contraceptive coverage,
     including related documentation standards.

     • Clarify general rules on the coverage of preventive services generally.

The regulations are applicable on the first day of the first plan or policy year beginning on or after Sept. 12, 2015.


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ACA Contraceptive Coverage Accommodation for Closely Held For-profit Businesses


        Final Rule Issued on ACA Contraceptive Coverage Exemptions

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On June 30, 2014, in Burwell v. Hobby Lobby Stores, Inc. et al., the U.S. Supreme Court created a narrow exception to the contraceptive mandate for closely held for-profit businesses that object to providing coverage for certain types of contraceptives based on their sincerely held religious beliefs.

In light of the Supreme Court’s decision in the Hobby Lobby case, the final regulations amend the definition of an “eligible organization” for purposes of the accommodations approach described above to include a closely held for-profit entity that has a religious objection to providing coverage for some or all of the contraceptive services otherwise required to be covered.

Under the final regulations, a qualifying closely held for-profit entity will not be required to contract, arrange, pay or refer for contraceptive coverage. Instead, payments for contraceptive services provided to participants and beneficiaries in the eligible organization’s plan would be provided or arranged separately by an issuer or a TPA.

The final rules define a qualifying closely held for-profit entity based on an existing definition in the Internal Revenue Code. For this purpose, a “closely held for-profit entity” is an entity that:

     • Is not a nonprofit entity

     • Has no publicly traded ownership interests

     • Has more than 50 percent of the value of its ownership interest owned
     directly or indirectly by five or fewer individuals

For purposes of this definition, all of the ownership interests held by members of a family are treated as being owned by a single individual. In addition, the rule provides that entities whose ownership structure is substantially similar to this definition can also qualify for the accommodation. An organization that is unsure about whether its ownership structure qualifies as “substantially similar” can seek guidance from HHS.

To be eligible for the accommodation, the for-profit entity’s highest governing body (such as its board of directors, board of trustees or owners, if managed directly by its owners) must adopt a resolution or similar action, under the organization’s applicable rules of governance and consistent with applicable state law, establishing that it objects to covering some or all of the contraceptive services on account of the owners’ sincerely held religious beliefs.

A qualifying closely held for-profit entity seeking the accommodation may use either of the two notification options available to qualifying nonprofit entities that seek the accommodation.

Under the Affordable Care Act (ACA), non-grandfathered health plans must cover certain preventive health services for women, including contraceptives, without imposing cost-sharing requirements for the services.

On July 10, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) released final regulations on the ACA’s women’s preventive care coverage requirement.

These regulations:

     • Finalize an accommodation for eligible nonprofit organizations and for-
     profit businesses with religious objections to providing contraceptive coverage,
     including related documentation standards.

     • Clarify general rules on the coverage of preventive services generally.

The regulations are applicable on the first day of the first plan or policy year beginning on or after Sept. 12, 2015.


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Disclosure of the Decision to Assert a Religious Objection to Contraceptive Services


        Final Rule Issued on ACA Contraceptive Coverage Exemptions

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A for-profit entity taking advantage of the accommodation must make its self-certification or notice of objection available for examination upon request by the first day of the plan year to which the accommodation applies. The self-certification or notice of objection must be maintained consistent with ERISA’s record retention requirements.

The final regulations do not establish any additional requirements to disclose the decision. The Departments believe that the current notice and disclosure standards for health plans provide individuals with an adequate opportunity to know that the employer has elected the accommodation for its group health plan and that they are entitled to separate payment for contraceptive services from another source without cost sharing.

The current standards require that, for each plan year to which the accommodation applies, a TPA that is required to provide or arrange payments for contraceptive services and a health insurance issuer required to provide payment for these services, provide to plan participants and beneficiaries written notice of the availability of separate payments for these services contemporaneous with (to the extent possible), but separate from, any application materials distributed in connection with enrollment or re-enrollment in health coverage.

Under the Affordable Care Act (ACA), non-grandfathered health plans must cover certain preventive health services for women, including contraceptives, without imposing cost-sharing requirements for the services.

On July 10, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) released final regulations on the ACA’s women’s preventive care coverage requirement.

These regulations:

     • Finalize an accommodation for eligible nonprofit organizations and for-
     profit businesses with religious objections to providing contraceptive coverage,
     including related documentation standards.

     • Clarify general rules on the coverage of preventive services generally.

The regulations are applicable on the first day of the first plan or policy year beginning on or after Sept. 12, 2015.


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ACA Contraceptive Coverage Exemptions Additional Clarifications on Coverage of Recommended Preventive Services


        Final Rule Issued on ACA Contraceptive Coverage Exemptions

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The final regulations include the following clarifications related to the women’s preventive care coverage requirement:

     • Scope of recommended preventive services: The regulations finalize
     the requirement to provide coverage without cost sharing with respect to the
     following three categories of recommendations and guidelines (in addition to those
     provided for in the Health Resources and Services Administration (HRSA)
     guidelines for women):

        ◦ Evidence-based items or services that have in effect a rating of “A” or “B”
        in the current recommendations of the U.S. Preventive Services Task Force

        ◦ Immunizations for routine use that have in effect a recommendation from
        the CDC’s Advisory Committee on Immunization Practices

        ◦ Evidence-informed preventive care and screenings for infants, children
        and adolescents, provided for in guidelines supported by HRSA

     • Office visits: The final regulations clarify that, when a recommended preventive
     service is not billed separately (or is not tracked as individual encounter data
     separately) from an office visit, plans and issuers must look to the primary purpose
     of the office visit when determining whether they may impose cost sharing with
     respect to the office visit. The Departments anticipate that the determination of the
     primary purpose of the visit will be resolved through normal billing and coding
     activities, as they are for other services.

     • Out-of-network providers: The final regulations do not require plans or issuers
     to provide coverage for recommended preventive services delivered by an out-of-
     network provider. However, the regulations clarify that a plan or issuer that does
     not have a provider in its network who can provide a particular recommended
     preventive service is required to cover the preventive service when performed by
     an out-of-network provider, and the plan or issuer may not impose cost sharing
     with respect to the preventive service.

     • Reasonable medical management: Plans and issuers may use reasonable
     medical management techniques to determine the frequency, method, treatment or
     setting for required preventive coverage items or services to the extent they are not
     specified in the relevant recommendation or guideline. A plan or issuer may rely on
     the relevant clinical evidence base and established reasonable medical
     management techniques to determine the frequency, method, treatment or
     setting for coverage of a recommended preventive health service.

     • Services not described: The final regulations clarify that a plan or issuer may
     cover preventive services in addition to those required to be covered under
     the ACA. For these additional preventive services, a plan or issuer may impose
     cost sharing at its discretion, consistent with applicable law. A plan or issuer
     may also impose cost sharing for a treatment that is not a recommended
     preventive service, even if the treatment results from a recommended
     preventive service.

     • Timing: The preventive coverage requirement took effect for plan years beginning
     on or after Sept. 23, 2010. Coverage pursuant to recommendations or guidelines
     issued after that date must be provided for plan years beginning one year after the
     date the recommendation or guideline is issued.

Also, required coverage must be provided through the end of the plan year, even if the recommendation or guideline changes during the plan year. This rule does not apply if a recommendation or guideline is downgraded to a “D” rating or if any related item or service is subject to a safety recall or is otherwise determined to pose a significant safety concern by an authorized federal agency.

Under the Affordable Care Act (ACA), non-grandfathered health plans must cover certain preventive health services for women, including contraceptives, without imposing cost-sharing requirements for the services.

On July 10, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) released final regulations on the ACA’s women’s preventive care coverage requirement.

These regulations:

     • Finalize an accommodation for eligible nonprofit organizations and for-
     profit businesses with religious objections to providing contraceptive coverage,
     including related documentation standards.

     • Clarify general rules on the coverage of preventive services generally.

The regulations are applicable on the first day of the first plan or policy year beginning on or after Sept. 12, 2015.


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