MFC Benefits LLC Blog

April 16, 2025
Learn more about class-action lawsuits that target health plan tobacco surcharges and the IRS issues ACA reporting guidance on individual statements. CLASS-ACTION LAWSUITS TARGET HEALTH PLAN TOBACCO SURCHARGES Numerous class-action lawsuits have recently been filed against employers alleging that health plan premium surcharges related to tobacco use violate federal compliance requirements. These lawsuits have been filed by current and former employees of major U.S. companies who have paid more in premiums due to their tobacco use, often hundreds of dollars more per employee per year. Employers commonly require tobacco users to pay an additional charge for health plan premiums, whether they use cigarettes, cigars, e-cigarettes or smokeless tobacco. To comply with federal law, tobacco surcharges must be offered through a wellness program that meets the Health Insurance Portability and Accountability Act’s (HIPAA) nondiscrimination requirements. In general, the lawsuits assert that the health plans violated HIPAA’s nondiscrimination rules by: • Not offering a reasonable alternative standard to avoid the surcharge (or only applying the premium reduction on a prospective basis after completing the alternative standard) • Not describing the availability of the alternative standard in all plan materials The lawsuits request various forms of relief, including reimbursing employees who paid the surcharges with interest, disgorging any benefits or profits, and paying all attorney fees and costs. Given the recent wave of litigation, employers that impose tobacco surcharges should review whether their wellness programs are administered in accordance with HIPAA’s requirements, including making available a reasonable alternative standard to qualify for the full reward and communicating the surcharge to employees in all materials. IRS ISSUES ACA REPORTING GUIDANCE ON INDIVIDUAL STATEMENTS The IRS has issued Notice 2025-15, providing guidance on the alternative manner of furnishing statements to covered individuals and full-time employees using Forms 1095-B and 1095-C in accordance with the Affordable Care Act’s (ACA) reporting requirements. The Paperwork Burden Reduction Act, enacted at the end of 2024, provides that reporting entities are no longer required to send Forms 1095-B and 1095-C to covered individuals and full-time employees unless a form is requested. Essentially, IRS Notice 2025-15 confirms that employers can satisfy the alternative manner of furnishing Forms 1095-C upon request if they comply with the alternative manner of furnishing Forms 1095-B, which has been in effect for the past few years. To take advantage of the alternative reporting method, IRS Notice 2025-15 confirms that an employer must post a clear and conspicuous notice on its website stating that individuals may receive a copy of their statement upon request. The notice must be posted by the furnishing deadline (e.g., March 3, 2025, for 2024 statements). It must include an email address, a physical address to which a request may be sent and a telephone number to contact the employer. Employers must retain the notice in the same location through Oct. 15 of the year following the calendar year to which the statement relates (e.g., Oct. 15, 2025, for 2024 statements). In addition, any request must be fulfilled by Jan. 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later. Employers must continue to comply with applicable state reporting requirements. The alternative furnishing method set forth in IRS Notice 2025-15 applies to federal reporting requirements. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
March 26, 2025
Learn more about the power of protein, a 5-minute daily walk, and preparing for tax-filing season. THE POWER OF PROTEIN Protein is having a moment, and it’s for good reason. While some focus on it for muscle-building, others view it from a weight-loss perspective. Regardless of personal goals, protein is a macronutrient essential for body function. It is made up of many building blocks called amino acids and is fundamental for good health. The Dietary Guidelines for Americans 2020–25 recommend that adults consume 10%-35% of their total calories from protein. Depending on their activity level, age and weight, some people might need more. Some people like to calculate their protein needs in grams instead of percentages. For example, if their daily needs are 2,000 calories, protein would make up 200-700 calories, which is 50-175 grams. Healthy protein sources include eggs, fish, lean meats and low-fat dairy. Good plant sources include nuts, seeds, beans and lentils. Health experts recommend spreading out your protein consumption throughout the day. Eating more protein at breakfast could also help decrease hunger and cravings later in the day. Keep in mind that protein shouldn’t make up your entire meal; it should accompany fruits, vegetables and whole grains. Most people get enough protein from whole foods, but protein supplements are popular alternatives, especially for vegans and lactose intolerant individuals. Benefits of Protein Protein is a vital part of one’s diet. As such, there are several benefits of protein, including the following: • Builds muscle mass and strength • Strengthens bones • Aids in injury recovery • Reduces hunger by keeping you full for long periods • Forms essential enzymes, hormones and vitamins Recognizing the multifaceted importance of protein underscores the need to incorporate protein sources into your diet to maintain optimal health. Talk to your doctor if you have any questions about your diet or how to develop a balanced eating plan. A DAILY 5-MINUTE WALK COULD MAKE A DIFFERENCE It’s easy to feel overwhelmed by fitness trends or goals. While research shows that 11 minutes of moderate-to-vigorous exercise daily may lower your risk of cancer, cardiovascular disease or premature death, another health expert is praising the accessible exercise form of walking. The National Jewish Health’s director of cardiovascular prevention and wellness expressed that even a short amount of walking—just five minutes—has health benefits and supports future exercise goals. Walks improve the body’s blood flow and boost creativity and productivity. Like any other exercise, walking also helps strengthen muscles and delivers oxygen to the brain and muscles. How to Walk More Each Day Fortunately, walking can easily be implemented into a routine. Consider the following tips for including more walking into your daily routine: • Make small goals. For example, you could take a five-minute walk at lunch each day. Doing so makes you more likely to succeed in maintaining a new walking habit. • Walk with friends. This encourages you to keep the habit because you know others are counting on you, and it also keeps the walks from becoming monotonous. • Set reminders. Decide when to walk during the day and set reminders. It’s easy to forget to take a break when you get into your work. • Diversify your routine. Change your walking routes to prevent boredom, or try walking at different speeds throughout your walk. • Listen to your body. Don’t be afraid to take time off or modify your routine. Pay attention to your body’s signals and take care of yourself so you can maintain your new routine. The key is to make movement a regular part of your day, even if it’s a five-minute walk. Talk to your doctor and discuss what works best for you to learn more about creating an active routine. PREPARING FOR TAX-FILING SEASON Tax season is here, so if you haven’t done so already, it’s time to gather all the appropriate information you need to file your 2024 tax returns. The federal tax return deadline is Tuesday, April 15, 2025. However, due to federal disaster relief, millions of Americans have extensions this year. Taxpayers in Alabama, Florida, Georgia, North Carolina and South Carolina, and parts of Alaska, New Mexico, Tennessee, Virginia and West Virginia have until May 1 to file their returns and pay taxes. The IRS also extended the deadline to Oct. 15 for victims of California wildfires. Many people elect to file their tax returns electronically. This can be done in various ways, such as using tax preparation software or consulting a tax professional. If you are filing with a paper form, there are certain documents you must include. The documentation needed may vary based on your employment status over the past year. If you have questions about your tax-filing situation, consult with a tax professional. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
March 10, 2025
Learn more about ERISA Fiduciary Breach Claims Dismissed in Prescription Drug Lawsuit and DOL Addresses Interaction Between the Federal FMLA and State PFML Programs. ERISA FIDUCIARY BREACH CLAIMS DISMISSED IN RESCRIPTION DRUG LAWSUIT On Jan 24, 2025, a U.S. District Court for the District of New Jersey dismissed two claims in a class-action lawsuit filed against Johnson & Johnson (J&J), which alleged that the company breached its fiduciary duties under ERISA by mismanaging its prescription drug benefits plan and costing the plan and its participants millions of dollars due to higher out-of-pocket costs for prescription drugs and higher premiums, among other things. In dismissing the two fiduciary breach claims, the court ruled that the plaintiff (an employee of J&J) lacked standing to bring a lawsuit. The court found the plaintiff's first claim, that she paid more in premiums due to the defendants' purported breach of fiduciary duty, did not sufficiently show evidence of an injury. Further, the outcome of the lawsuit would not affect the plaintiff's future benefit payments, and the plaintiff failed to show that the defendant's specific conduct resulted in higher premiums. Regarding the plaintiff’s second claim that she paid higher prices for drugs under the plans and thus paid more out of pocket, the court acknowledged that she suffered an injury that was traceable to the defendants’ alleged ERISA violations. Notwithstanding, the plaintiff lacked standing based on this injury because a favorable decision would not be able to compensate her for the money she already paid, given that she had reached her prescription drug cap for each year asserted in the complaint. While the J&J ruling can be viewed favorably for employers in their roles as plan sponsors, the outcome of fiduciary litigation that was filed after the J&J case remains to be seen. Factors such as plan design and the specific allegations regarding how the defendants breached their fiduciary duties could result in different outcomes. DOL ADDRESSES INTERACTION BETWEEN THE FEDERAL FMLA AND STATE PFML PROGRAMS In Opinion Letter FMLA 2025-01-A, the U.S. Department of Labor (DOL) addressed the interaction between state and local paid family and medical leave (PFML) and leave taken under the federal Family and Medical Leave Act (FMLA). The FMLA provides 12 weeks of unpaid, job-protected leave per year for specified family and medical reasons. While FMLA leave is unpaid, the law allows the employee to elect, or an employer to require the employee, to substitute accrued employer-provided paid leave (such as paid vacation or paid sick leave) for any part of the unpaid FMLA leave. The DOL’s opinion letter states that although the FMLA statute and regulations do not address state or local PFML, employers must designate PFML as FMLA leave when it is also FMLA-qualifying. Furthermore, the employer and employee may agree to use the employee’s accrued paid leave from the employer to supplement the PFML payments, as permitted by state law. However, the FMLA’s substitution provision does not apply. Neither the employer nor the employee may unilaterally require that employer-provided accrued paid leave run concurrently with PFML taken for an FMLA purpose. Other than the substitution provision, all of the protections of the FMLA, including its anti-retaliation provisions, apply during the time the PFML and the FMLA leave run concurrently. Additionally, the substitution provision would apply for any remaining FMLA leave once the state or local paid leave is exhausted. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
March 3, 2025
Learn more about 2025's best diet, building heart-healthy habits, and the benefits of strength training. 2025'S BEST DIET: THE MEDITERRANEAN For the eighth consecutive year, U.S. News & World Report named the Mediterranean diet the world's best overall diet. This diet can help support brain function, promote heart health and regulate blood sugar levels. Research also suggests that this well-balanced eating pattern can help prevent some chronic diseases and increase longevity. Because the Mediterranean diet is nonrestrictive, almost anyone can follow it and adapt it to their personal and cultural food preferences. The winning meal plan emulates how people in the Mediterranean region have traditionally eaten, focusing on whole grains and heart-healthy fats. These foods are encouraged in the diet: • Fruits (e.g., apples, bananas, grapes, melons, oranges, peaches, pears and strawberries) • Vegetables (e.g., artichokes, broccoli, Brussels sprouts, carrots, cucumbers, kale, spinach, onions, spinach and sweet potatoes) • Nuts and seeds (e.g., almonds, cashews, hazelnuts, macadamia nuts, pumpkin seeds, peanut butter, sunflower seeds and walnuts) • Legumes (e.g., beans, chickpeas, lentils, peanuts and peas) • Whole grains (e.g., barley, buckwheat, brown rice, oats and whole-wheat bread and pasta) • Fish and seafood (e.g., crab, mussels, oysters, salmon, sardines, shrimp, trout and tuna) • Herbs and spices (e.g., basil, cinnamon, garlic, mint, nutmeg, rosemary and sage) • Healthy fats (e.g., avocados, avocado oil, extra virgin olive oil and olives) The meal plan also encourages poultry (e.g., chicken, duck and turkey), eggs, cheese and yogurt in moderation. Sweets, red meat and other highly processed foods should be limited. A nonrestrictive healthy eating regimen such as the Mediterranean diet may be easier to follow and stay committed to. After all, you can start building Mediterranean-inspired meals with foods you already love or by incorporating more fruits and vegetables into your meals and snacks. U.S. News & World Report also ranked diets for 21 categories based on health and lifestyle goals, so check out the full results. Talk to your doctor about any diet-related questions. BUILDING HEART-HEALTHY HABITS Heart disease is the leading cause of death in the country for both men and women, accounting for 1 out of every 5 deaths. Cardiovascular disease and the conditions that lead to it can happen at any age. Some types of heart disease include arrhythmia, heart failure, heart attack and stroke. The American Heart Association predicts that roughly 61% of U.S. adults will have some type of cardiovascular disease by 2050. A heart-healthy lifestyle can reduce the risk of heart disease, and small changes can make a difference. Consider these incorporating these practical tips: • Get screened . A heart disease screening checks your blood pressure, cholesterol and blood glucose levels. If you don’t know these numbers, a baseline screening is a starting point for monitoring your health. • Eat healthy. It’s crucial to control portion sizes and consume a balanced diet full of fruits, vegetables, whole grains and protein. Limit fast, fried and processed foods, saturated and trans fats, and sodium. • Be active . It’s important to engage in aerobic activity for at least 150 minutes weekly and muscle-strengthening activities two times per week. Flexibility workouts, such as stretching and balance, support musculoskeletal health and can help you keep up with your exercises. • Avoid or quit smoking . Nicotine raises blood pressure, so quit smoking or vaping. Breathing secondhand smoke also affects your heart. February is American Heart Month, which is a great time to take charge of your heart health and get screened. Your doctor can also provide more information about heart health and warning signs. THE BENEFITS OF STRENGTH TRAINING Strength training, also known as weight lifting or resistance training, is growing as a fitness trend as people recognize its impact on long-term health. The goal is to use your body weight or equipment (e.g., free weights, kettlebells and resistance bands) to build muscle mass and endurance. It’s recommended to incorporate muscle-strengthening exercises at least twice a week, combined with aerobic activity. This type of exercise isn’t just for athletes; anyone can benefit from regular strength training. Think of it as training for everyday life. Strength training allows you to perform daily tasks—such as climbing stairs, lifting children and doing household chores— more easily, which is especially important as you age. Regular strength training may result in: • Increased muscle mass • Stronger, denser bones • Boosted metabolism • Better flexibility and mobility • Reduced risk of injury or falls • Lowered risk of heart disease and diabetes • Elevated mood, self-esteem and brain health Strength training provides several benefits, but start slowly and focus on your form first. As you get more comfortable, you can add more weight or resistance or increase repetitions. If this feels intimidating, online videos, small group classes or trainers can help. Always speak with your health care provider before beginning a new exercise program. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
February 12, 2025
Learn more about the new ACA Reporting, Penalty Relief and the DOL increasing Civil Penalty Amounts for 2025. NEW ACA REPORTING AND PENALTY RELIEF At the end of 2024, Congress passed two new laws, the Paperwork Burden Reduction Act and the Employer Reporting Improvement Act, which eased Affordable Care Act (ACA) reporting requirements for employers and set new limits on the IRS’ assessment of “pay-or-play” penalties. As background, the ACA requires applicable large employers (ALEs) and non-ALEs with self-insured health plans to provide information to the IRS about the health plan coverage they offer (or do not offer) to their employees. They must also provide related statements to individuals regarding their health plan coverage. Before 2025, ALEs were required to provide each fulltime employee with a statement regarding their health coverage (Form 1095-C) within 30 days of Jan. 31 each year. The IRS has allowed non-ALEs with self-insured health plans to provide health coverage statements (Forms 1095-B) to covered individuals upon request only. Beginning in 2025, this flexibility is extended to ALEs for furnishing Forms 1095-C. Accordingly, employers are no longer required to send Forms 1095-C and 1095-B to individuals unless a form is requested . Employers must give individuals timely notice of this option in accordance with any requirements set by the IRS. Requests must be fulfilled by Jan. 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later. The statements may be provided electronically to individuals who have consented in the past. ALEs and non-ALEs with self-insured plans are still required to file ACA returns with the IRS. The deadline for electronic filing is March 31, 2025. In addition, ALEs are subject to IRS penalties if they do not offer affordable minimum essential coverage under the ACA’s employer shared responsibility (pay-or-play) rules. The new legislation increases the time ALEs have to respond to IRS penalty assessment warning letters from 30 days to 90 days. The legislation also imposes a six-year time limit on when the IRS can try to collect assessments. DOL INCREASES CIVIL PENALTY AMOUNTS FOR 2025 On Jan. 10, 2025, the U.S. Department of Labor (DOL) published the 2025 inflation-adjusted civil monetary penalties that may be assessed for a wide range of employee benefit-related violations. To maintain their deterrent effect, the DOL is required to adjust these penalties for inflation no later than Jan. 15 of each year. Key penalty increases include the following: • Summary of Benefits and Coverage (SBC) : Failure to provide group health plan participants and beneficiaries with an SBC may now result in a penalty of up to $1,443 per participant or beneficiary. • Form 5500 filings : Failure to file an annual Form 5500 with the DOL can now result in a penalty of up to $2,739 per day. • Children’s Health Insurance Program (CHIP) notice: Failure to provide the annual notice regarding CHIP coverage opportunities may now result in a penalty of up to $145 per day (each employee is a separate violation). • 401(k) disclosures : Failure to provide blackout notices and notice of the right to divest employer securities may now result in penalties of up to $173 per day. • DOL-requested plan information: Failure to provide plan-related information requested by the DOL can now result in penalties of up to $195 per day, not to exceed $1,956 per request. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
January 22, 2025
Learn more about PCORI Fee Adjustments and the new Mental Health Parity Requirements. PCORI FEE AMOUNT ADJUSTED FOR 2025 The IRS recently issued Notice 2024-83 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after Oct. 1, 2024, and before Oct. 1, 2025. The updated PCORI fee amount is $3.47 multiplied by the average number of lives covered under the plan. For plan years that ended on or after Oct. 1, 2023, and before Oct. 1, 2024, the PCORI fee amount is $3.22 multiplied by the average number of lives covered under the plan. The PCORI fee is imposed on health insurance issuers and self-insured plan sponsors to fund comparative effectiveness research. It applies through the plan or policy year ending before Oct. 1, 2029. PCORI fees are reported and paid annually on IRS Form 720 (Quarterly Federal Excise Tax Return). These fees are due each year by July 31 of the year following the last day of the plan year. For plan years ending in 2024, the PCORI fee is due by July 31, 2025. Employers with self insured health plans should have reported and paid PCORI fees for 2023 by July 31, 2024. The PCORI fees are calculated based on the average number of covered lives under the plan or policy. This generally includes employees and their enrolled spouses and dependents unless the plan is a health reimbursement arrangement (HRA) or health flexible spending account (FSA). Final rules outline a number of alternatives for issuers and plan sponsors to determine the average number of covered lives. NEW MENTAL HEALTH PARITY REQUIREMENTS TAKE EFFECT IN 2025 In September 2024, federal agencies released a final rule to strengthen the requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA). The final rule is designed to help ensure individuals do not face greater restrictions to obtaining mental health and substance use disorder (MH/SUD) benefits than they would face for medical/surgical (M/S) benefits. Significantly, the final rule adds protections against more restrictive nonquantitative treatment limitations (NQTLs), such as network composition, out-of-network reimbursement rates and prior authorization requirements. For example, the final rule requires group health plans and health insurance issuers to collect and evaluate data related to the NQTLs they place on MH/SUD care and make changes if the data shows they are providing insufficient access. The final rule generally applies for plan years beginning on or after Jan. 1, 2025; however, certain key requirements, such as the NQTL data evaluation requirements, apply for plan years beginning on or after Jan. 1, 2026. The final rule also establishes minimum standards for developing comparative analyses to assess whether an NQTL, as written and in operation, complies with MHPAEA’s requirements. Plans and issuers that cover both M/S benefits and MH/SUD benefits and impose NQTLs on MH/SUD benefits must perform and document a comparative analysis of the design and application of each applicable NQTL. In many cases, issuers and third-party administrators will help prepare comparative analyses for employer sponsored health plans. However, the final rule requires the comparative analyses for ERISA-covered plans to also include a plan fiduciary’s certification that they have engaged in a prudent process and monitored their service providers. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
December 10, 2024
Learn more about mindfulness, daylight savings time, and 2 key aging points. FALL INTO MINDFULNESS The changing seasons can help you prioritize your physical, emotional and mental health by presenting the opportunity to start new routines or cut out unhealthy habits. Autumn is a great time to embrace the concept of mindfulness, the practice of being fully present in the moment. Mindfulness can help people embrace seasonal transitions and make space for new experiences and personal growth. Making the Most of the Season Fall is a season of transition, making it a good time for building resilience and practicing mindfulness. Trees shed their leaves, and the days grow shorter; this natural process may mirror personal lives, where change is inevitable. Consider the following ways to work with the energy of fall to amplify your mindfulness practice: • Start each day with an intention . People often set goals and intentions seasonally, making fall the perfect time to refocus your time and energy. Setting intentions can help align your values with your purpose. • Keep a gratitude journal . Make a daily habit of noting what you’re grateful for during the fall. Reflecting on these moments of gratitude can help you appreciate the season more deeply. • Practice meditation . Take a moment each day to meditate and practice deep, mindful breathing. This exercise can help you stay grounded and calm during the busyness of the season. • Take a nature walk . Take hikes or leisurely walks through parks, forests or your neighborhood to soak in the beauty of fall. Instead of listening to music or a podcast, try a “quiet walk” and leave your phone at home, or set the volume to silent so you can stay focused on the experience. • Go photo walking . Alternatively, take your phone or camera along during a nature walk to capture the season’s sights. Not only will you get movement in, but you can also unleash your creativity and connect with your surroundings. • Cook a seasonal recipe . Savor the seasonal flavors and cook a delicious homemade meal or bake a sweet treat. Fall flavors (e.g., apple, pumpkin, maple, ginger, cinnamon and sage) can add a comforting touch to your cooking. Like with any exercise, regular practice builds mindfulness, so find ways to incorporate mindful activities or insert them into an existing daily or weekly routine. Contact a doctor for more information on improving your mindfulness. DAYLIGHT SAVING TIME Most of the United States shifts between standard and daylight saving time (DST) each year in an effort to “save” natural light. Clocks will get set one hour back on Sunday, Nov. 3. Although you may be excited about gaining another hour in your day, DST can wreak havoc on your physical and cognitive health for several days, weeks or even months. The disruption of DST can negatively impact your health. Your internal clock regulates critical processes, including the immune system. Interruptions to the circadian rhythm, your body’s 24-hour biological cycle that regulates wake and sleep, can also impair your focus and judgment. In fact, research revealed that fatal traffic accidents increased by 6% in the week following DST. Fortunately, there are ways to increase your odds of a smooth DST transition. While you may be tempted to use the extra hour to indulge in various activities, health experts recommend using that time for sleep. To help make the DST transition easier, consider going to bed 15-20 minutes early in the days beforehand to help your body get used to the difference. If you have specific health concerns, talk to your doctor. Helping Your Body Adjust to the Time Change If your state follows DST, consider these tips to protect your circadian rhythm: exercise in the morning, prioritize daylight exposure, keep a regular sleep routine, and remove sleep disturbances. STUDY REVEALS 2 KEY AGING POINTS The body undergoes numerous changes—externally and internally—as people age. While it’s traditionally believed that humans age gradually, research from the Stanford University School of Medicine revealed that people age in two significant “bursts” during their lives. Researchers found that humans undergo major changes in their bodies’ molecules and microorganisms around ages 44 and 60. These changes potentially impact several aspects of a person’s health. For those in their 40s, researchers found significant molecular changes related to alcohol, caffeine and lipid metabolism; cardiovascular disease; and skin and muscle. At 60, the largest molecule changes were associated with cardiovascular disease, immune regulation, kidney function, carbohydrate and caffeine metabolism, and skin and muscle. The study recommended lifestyle changes, such as exercising more and drinking less alcohol, when people near these key aging points in their 40s and 60s. Talk to your doctor to learn more. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2024 Zywave, Inc. All rights reserved. Download the PDF copy here.
November 19, 2024
Learn more about the final forms and instructions for 2024 ACA Reporting and the IRS releases Health FSA limits for 2025. FINAL FORMS AND INSTRUCTIONS FOR 2024 ACA REPORTING NOW AVAILABLE The IRS has released final 2024 forms and instructions for reporting under Internal Revenue Code Sections 6055 and 6056: • 2024 Forms 1094-B and 1095-B (and instructions) can be used by providers of minimum essential coverage— including self-insured plan sponsors that are not applicable large employers (ALEs)—to report under Section 6055. • 2024 Forms 1094-C and 1095-C (and instructions) can be used by ALEs to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans. No major changes were made to the final forms and instructions for 2024 reporting. As a reminder, the electronic filing threshold for returns required to be filed on or after Jan. 1, 2024, is 10 or more returns (originally, the threshold was 250 or more returns). This requirement applies in the aggregate to certain information returns. Accordingly, a reporting entity may be required to file fewer than 10 of the applicable Form 1094 and 1095 but still have an electronic filing obligation based on other kinds of information returns filed (e.g., Forms W-2 and 1099). Employers should become familiar with the forms and instructions for 2024 calendar year reporting and prepare to promptly furnish individual statements and file returns. Individual statements for 2024 must be furnished by March 3, 2025 . Electronic IRS returns for 2024 must be filed by March 31, 2025 . IRS RELEASES HEALTH FSA LIMITS FOR 2025 On Oct. 22, 2024, the IRS released Revenue Procedure 2024-40 (Rev. Proc. 24-40), which includes the inflation-adjusted limits for 2025 for health flexible spending accounts (FSAs). For plan years beginning in 2025, the adjusted dollar limit on employees’ pre-tax contributions to health FSAs increases to $3,300. This is a $100 increase from the 2024 health FSA limit of $3,200. As background, the Affordable Care Act (ACA) imposes a dollar limit on employees’ salary reduction contributions to health FSAs. This limit started at $2,500 for plan years beginning on or after Jan. 1, 2013, and has been adjusted for inflation for subsequent plan years. Employers should ensure their health FSAs will not allow employees to make pre-tax contributions over $3,300 for the 2025 plan year. Also, employers should confirm their health FSA contribution limit is included in the plan’s documents and communicate it to employees at enrollment time. In addition, as an exception to the use-or-lose rule, employers with health FSAs may allow employees to carry over a certain amount of funds remaining at the end of a plan year to reimburse eligible expenses incurred in the plan year immediately following. The maximum carryover amount is adjusted annually for inflation. For 2025, Rev. Proc. 24-40 increases the maximum carryover limit to $660 (from $640 for 2024). Provided to you by MFC Benefits, LLC © 2024 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
October 31, 2024
Learn more about this year's flu season, the power of breathwork, and how to plan for a stress-free holiday season. WHAT TO KNOW ABOUT THIS YEAR'S FLU SEASON In the United States, influenza (flu) season lasts from October through May, with peak flu activity between December and March. What's more, flu season in the Southern Hemisphere often indicates what's to come in the United States. Data revealed that the 2024 flu season in the Southern Hemisphere was similar to previous flu seasons. With the potential for this year's flu season to be severe in the United States, vaccination remains the most effective way to prevent the flu, especially severe disease and hospitalization. The U.S. Centers for Disease Control and Prevention (CDC) estimates that the flu caused between 9 million and 41 million illnesses annually between 2010 and 2023. How to Stay Healthy The flu can cause serious complications for people of any age, but children and older adults are especially vulnerable. To help keep your household healthy this flu season, consider these tips: - Get the flu vaccine. Being vaccinated against the flu is your best chance of preventing the illness. The CDC recommends that anyone aged 6 months and older get a flu shot every year. - Avoid close contact with people who are sick, and stay away from others when you feel unwell. Because flu, cold and COVID-19 symptoms are similar, doctors say it's best to get tested to know what you have. - Wash your hands often using soap and warm water to protect against germs. If soap and water are unavailable, use an alcohol-based hand sanitizer. - Cover your mouth and nose. Cough or sneeze into a tissue or your elbow, and dispose of tissues immediately. - Get seven to nine hours of quality sleep each night to boost your immune system. - Exercise regularly to strengthen your body and make it more resilient against infections, including the flu. - Stay hydrated and eat a nutritious diet rich in whole grains, lean proteins, fruits, vegetables, and fiber. Experts recommend getting vaccinated against the flu by the end of October, so don't delay getting your shot. Contact your doctor today to learn more about vaccines. THE POWER OF BREATHWORK Breathwork, an ancient practice now embraced in modern wellness, benefits physical and mental health. By consciously altering your breathing patterns, you can: - Reduce stress. You'll activate the parasympathetic nervous system, promoting relaxation and reducing chronic stress. - Enhance focus. Slow, deep breathing can improve your concentration and emotional resilience. - Boost overall health. Breathwork positively impacts physical health, emotional well-being and sleep quality. Taking a few intentional breaths can make a difference, so try the techniques below. COMMON BREATHING TECHNIQUES - Equal breathing: inhale and exhale for the same amount of time, such as breathing in for four seconds and out for four. - Box breathing: mirroring the shape of a box, inhale for a count of four, hold for four, exhale for four and hold for four. - Deep breathing: for the 4-7-8 technique, breathe in for a count of four seconds, hold for seven and breathe out for eight. START PLANNING NOW FOR A STRESS-FREE HOLIDAY SEASON While the holiday season often brings joy, it can also cause stress for many individuals. Top holiday stressors include budgeting, managing multiple commitments and finding the perfect gifts. Fortunately, getting organized and planning what you can do ahead of time can help reduce your holiday stress. Consider these tips: - Write down any known commitments . Are you hosting a holiday dinner? Does your child's school have a seasonal concert? Make a list of your commitments will help you plan your time accordingly and avoid double-booking yourself. - Create your budget now . If you're stressed about how your holiday spending will impact you after the season ends, you're not alone. Set and stick to a realistic budget. Remember that a gift's sentiment is more important than the cost. - Start shopping early. Sometimes, you can get great deals on presents before the holiday season hits. Also, you can avoid the scenario (and stress) of not being able to get the gift you want because it's sold out. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2024 Zywave, Inc. All rights reserved. Download the PDF copy here.
October 17, 2024
Learn more about the ACA's Pay-or-Play Affordability Percentage Increases for 2025 and the Mental Health Parity Law. ACA'S PAY-OR-PLAY AFFORDABILITY PERCENTAGE INCREASES FOR 2025 On Sept. 6, 2024, the IRS released the affordability percentage threshold for 2025 plan years under the Affordable Care Act's (ACA) pay-or-play rules. These rules require ALEs to offer affordable, minimum-value health coverage to their full-time employees (and dependents) or risk paying a penalty. For plan years beginning in 2025, employer-sponsored coverage will be considered affordable under the ACA's pay-or-play rules if the employee's required contribution for self-only coverage does not exceed 9.02% of their household income for the year. This is an increase from the affordability percentage for 2024 plan years (8.39%). Due to this increase, applicable large employers (ALEs) may have more flexibility when setting employee contribution levels for the 2025 plan year. The ACA's affordability test applies only to the portion of the annual premiums for self-only coverage and does not include any additional cost for family coverage. Also, if an employer offers multiple health coverage options, the affordability test applies to the lowest-cost option that provides minimum value. Because an employer generally will not know an employee's household income, the IRS has provided three optional safe harbors that ALEs may use to determine affordability based on information that is available to them: the Form W-2 safe harbor, the rate of pay safe harbor and the federal poverty level safe harbor. FINAL RULE STRENGTHENS MENTAL HEALTH PARITY LAW On Sept. 9, 2024, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released a final rule to strengthen the requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA). The final rule is designed to ensure that individuals do not face greater restrictions to obtaining mental health and substance use disorder (MH/SUD) benefits than they would face for medical/surgical benefits. The final rule adds protections against more restrictive nonquantitative treatment limitations (NQTLs), such as preauthorization requirements and network composition standards. For example, the final rule requires group health plans and health insurance issuers to collect and evaluate data related to the NQTLs they place on MH/SUD care and make changes if the data shows they are providing insufficient access. The final rule also establishes minimum standards for developing comparative analyses to assess whether NQTLs comply with MHPAEA's requirements. In most cases, employers rely on issuers and third-party vendors to prepare comparative analyses for their health plans. However, the final rule requires the comparative analyses for health plans covered by ERISA to include a fiduciary's certification that they have engaged in a prudent process and monitored their service providers. The final rule generally applies for plan years beginning on or after Jan. 1, 2025; however, certain key requirements, such as NQTL data requirements, apply for plan years beginning on or after Jan.1, 2026. Provided to you by MFC Benefits, LLC © 2024 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Show More
April 16, 2025
Learn more about class-action lawsuits that target health plan tobacco surcharges and the IRS issues ACA reporting guidance on individual statements. CLASS-ACTION LAWSUITS TARGET HEALTH PLAN TOBACCO SURCHARGES Numerous class-action lawsuits have recently been filed against employers alleging that health plan premium surcharges related to tobacco use violate federal compliance requirements. These lawsuits have been filed by current and former employees of major U.S. companies who have paid more in premiums due to their tobacco use, often hundreds of dollars more per employee per year. Employers commonly require tobacco users to pay an additional charge for health plan premiums, whether they use cigarettes, cigars, e-cigarettes or smokeless tobacco. To comply with federal law, tobacco surcharges must be offered through a wellness program that meets the Health Insurance Portability and Accountability Act’s (HIPAA) nondiscrimination requirements. In general, the lawsuits assert that the health plans violated HIPAA’s nondiscrimination rules by: • Not offering a reasonable alternative standard to avoid the surcharge (or only applying the premium reduction on a prospective basis after completing the alternative standard) • Not describing the availability of the alternative standard in all plan materials The lawsuits request various forms of relief, including reimbursing employees who paid the surcharges with interest, disgorging any benefits or profits, and paying all attorney fees and costs. Given the recent wave of litigation, employers that impose tobacco surcharges should review whether their wellness programs are administered in accordance with HIPAA’s requirements, including making available a reasonable alternative standard to qualify for the full reward and communicating the surcharge to employees in all materials. IRS ISSUES ACA REPORTING GUIDANCE ON INDIVIDUAL STATEMENTS The IRS has issued Notice 2025-15, providing guidance on the alternative manner of furnishing statements to covered individuals and full-time employees using Forms 1095-B and 1095-C in accordance with the Affordable Care Act’s (ACA) reporting requirements. The Paperwork Burden Reduction Act, enacted at the end of 2024, provides that reporting entities are no longer required to send Forms 1095-B and 1095-C to covered individuals and full-time employees unless a form is requested. Essentially, IRS Notice 2025-15 confirms that employers can satisfy the alternative manner of furnishing Forms 1095-C upon request if they comply with the alternative manner of furnishing Forms 1095-B, which has been in effect for the past few years. To take advantage of the alternative reporting method, IRS Notice 2025-15 confirms that an employer must post a clear and conspicuous notice on its website stating that individuals may receive a copy of their statement upon request. The notice must be posted by the furnishing deadline (e.g., March 3, 2025, for 2024 statements). It must include an email address, a physical address to which a request may be sent and a telephone number to contact the employer. Employers must retain the notice in the same location through Oct. 15 of the year following the calendar year to which the statement relates (e.g., Oct. 15, 2025, for 2024 statements). In addition, any request must be fulfilled by Jan. 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later. Employers must continue to comply with applicable state reporting requirements. The alternative furnishing method set forth in IRS Notice 2025-15 applies to federal reporting requirements. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
March 26, 2025
Learn more about the power of protein, a 5-minute daily walk, and preparing for tax-filing season. THE POWER OF PROTEIN Protein is having a moment, and it’s for good reason. While some focus on it for muscle-building, others view it from a weight-loss perspective. Regardless of personal goals, protein is a macronutrient essential for body function. It is made up of many building blocks called amino acids and is fundamental for good health. The Dietary Guidelines for Americans 2020–25 recommend that adults consume 10%-35% of their total calories from protein. Depending on their activity level, age and weight, some people might need more. Some people like to calculate their protein needs in grams instead of percentages. For example, if their daily needs are 2,000 calories, protein would make up 200-700 calories, which is 50-175 grams. Healthy protein sources include eggs, fish, lean meats and low-fat dairy. Good plant sources include nuts, seeds, beans and lentils. Health experts recommend spreading out your protein consumption throughout the day. Eating more protein at breakfast could also help decrease hunger and cravings later in the day. Keep in mind that protein shouldn’t make up your entire meal; it should accompany fruits, vegetables and whole grains. Most people get enough protein from whole foods, but protein supplements are popular alternatives, especially for vegans and lactose intolerant individuals. Benefits of Protein Protein is a vital part of one’s diet. As such, there are several benefits of protein, including the following: • Builds muscle mass and strength • Strengthens bones • Aids in injury recovery • Reduces hunger by keeping you full for long periods • Forms essential enzymes, hormones and vitamins Recognizing the multifaceted importance of protein underscores the need to incorporate protein sources into your diet to maintain optimal health. Talk to your doctor if you have any questions about your diet or how to develop a balanced eating plan. A DAILY 5-MINUTE WALK COULD MAKE A DIFFERENCE It’s easy to feel overwhelmed by fitness trends or goals. While research shows that 11 minutes of moderate-to-vigorous exercise daily may lower your risk of cancer, cardiovascular disease or premature death, another health expert is praising the accessible exercise form of walking. The National Jewish Health’s director of cardiovascular prevention and wellness expressed that even a short amount of walking—just five minutes—has health benefits and supports future exercise goals. Walks improve the body’s blood flow and boost creativity and productivity. Like any other exercise, walking also helps strengthen muscles and delivers oxygen to the brain and muscles. How to Walk More Each Day Fortunately, walking can easily be implemented into a routine. Consider the following tips for including more walking into your daily routine: • Make small goals. For example, you could take a five-minute walk at lunch each day. Doing so makes you more likely to succeed in maintaining a new walking habit. • Walk with friends. This encourages you to keep the habit because you know others are counting on you, and it also keeps the walks from becoming monotonous. • Set reminders. Decide when to walk during the day and set reminders. It’s easy to forget to take a break when you get into your work. • Diversify your routine. Change your walking routes to prevent boredom, or try walking at different speeds throughout your walk. • Listen to your body. Don’t be afraid to take time off or modify your routine. Pay attention to your body’s signals and take care of yourself so you can maintain your new routine. The key is to make movement a regular part of your day, even if it’s a five-minute walk. Talk to your doctor and discuss what works best for you to learn more about creating an active routine. PREPARING FOR TAX-FILING SEASON Tax season is here, so if you haven’t done so already, it’s time to gather all the appropriate information you need to file your 2024 tax returns. The federal tax return deadline is Tuesday, April 15, 2025. However, due to federal disaster relief, millions of Americans have extensions this year. Taxpayers in Alabama, Florida, Georgia, North Carolina and South Carolina, and parts of Alaska, New Mexico, Tennessee, Virginia and West Virginia have until May 1 to file their returns and pay taxes. The IRS also extended the deadline to Oct. 15 for victims of California wildfires. Many people elect to file their tax returns electronically. This can be done in various ways, such as using tax preparation software or consulting a tax professional. If you are filing with a paper form, there are certain documents you must include. The documentation needed may vary based on your employment status over the past year. If you have questions about your tax-filing situation, consult with a tax professional. This article is intended for informational purposes only and is not intended to be exhaustive, nor should any discussion or opinions be construed as professional advice. Readers should contact a health professional for appropriate advice. © 2025 Zywave, Inc. All rights reserved. Download the PDF copy here.
March 10, 2025
Learn more about ERISA Fiduciary Breach Claims Dismissed in Prescription Drug Lawsuit and DOL Addresses Interaction Between the Federal FMLA and State PFML Programs. ERISA FIDUCIARY BREACH CLAIMS DISMISSED IN RESCRIPTION DRUG LAWSUIT On Jan 24, 2025, a U.S. District Court for the District of New Jersey dismissed two claims in a class-action lawsuit filed against Johnson & Johnson (J&J), which alleged that the company breached its fiduciary duties under ERISA by mismanaging its prescription drug benefits plan and costing the plan and its participants millions of dollars due to higher out-of-pocket costs for prescription drugs and higher premiums, among other things. In dismissing the two fiduciary breach claims, the court ruled that the plaintiff (an employee of J&J) lacked standing to bring a lawsuit. The court found the plaintiff's first claim, that she paid more in premiums due to the defendants' purported breach of fiduciary duty, did not sufficiently show evidence of an injury. Further, the outcome of the lawsuit would not affect the plaintiff's future benefit payments, and the plaintiff failed to show that the defendant's specific conduct resulted in higher premiums. Regarding the plaintiff’s second claim that she paid higher prices for drugs under the plans and thus paid more out of pocket, the court acknowledged that she suffered an injury that was traceable to the defendants’ alleged ERISA violations. Notwithstanding, the plaintiff lacked standing based on this injury because a favorable decision would not be able to compensate her for the money she already paid, given that she had reached her prescription drug cap for each year asserted in the complaint. While the J&J ruling can be viewed favorably for employers in their roles as plan sponsors, the outcome of fiduciary litigation that was filed after the J&J case remains to be seen. Factors such as plan design and the specific allegations regarding how the defendants breached their fiduciary duties could result in different outcomes. DOL ADDRESSES INTERACTION BETWEEN THE FEDERAL FMLA AND STATE PFML PROGRAMS In Opinion Letter FMLA 2025-01-A, the U.S. Department of Labor (DOL) addressed the interaction between state and local paid family and medical leave (PFML) and leave taken under the federal Family and Medical Leave Act (FMLA). The FMLA provides 12 weeks of unpaid, job-protected leave per year for specified family and medical reasons. While FMLA leave is unpaid, the law allows the employee to elect, or an employer to require the employee, to substitute accrued employer-provided paid leave (such as paid vacation or paid sick leave) for any part of the unpaid FMLA leave. The DOL’s opinion letter states that although the FMLA statute and regulations do not address state or local PFML, employers must designate PFML as FMLA leave when it is also FMLA-qualifying. Furthermore, the employer and employee may agree to use the employee’s accrued paid leave from the employer to supplement the PFML payments, as permitted by state law. However, the FMLA’s substitution provision does not apply. Neither the employer nor the employee may unilaterally require that employer-provided accrued paid leave run concurrently with PFML taken for an FMLA purpose. Other than the substitution provision, all of the protections of the FMLA, including its anti-retaliation provisions, apply during the time the PFML and the FMLA leave run concurrently. Additionally, the substitution provision would apply for any remaining FMLA leave once the state or local paid leave is exhausted. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
Show More