Author Archives: jmhsmola

The Power of Wellness in the Workplace


Clients enjoyed a morning of wellness on May 24th with Keynote Speaker Lisa Norsen, Chief Wellness Officer, UR Medicine Employee Wellness, followed by a Mindful Movement Activity with Marla Pellitier, Inward Office. Smola Consulting Clients, Seneca Falls CSD and Goodwill of the Finger Lakes also shared some “Proof Positive” wellness success from their organizations.

Rick Amundson, Smola Consulting Wellness Consultant also shared how he can support clients with their wellness initiatives.

Smola Consulting’s next client wellness event is scheduled for September 27th.

Smola Consulting Teams Up Again in 2018 to Support the Lollypop Farm Tails of Hope Telethon – March 2018.


The Tails of Hope Telethon is the annual fundraiser that helps to fund the many great programs for pets in need. Smola Consulting supports this important annual fundraiser so that Lollypop Farm can provide food, shelter, veterinary services, and other forms of compassionate care for hundreds of pets every day. We are committed to providing support so that the many wonderful programs can continue to benefit the people and pets in our community.

Knighthawks and Smola Consulting Team Up to Support a Great Community Organization – Association for the Blind and Visually Impaired (ABVI)- December 2017

Smola Consulting is proud to partner with the Rochester Knighthawks to benefit one of Rochester’s great community assets, The Association for the Blind and Visually Impaired , an affiliate of Goodwill of the Finger Lakes.. Smola Consulting is donating $3 for each save the Knighthawks make during the 2018-2018 season. Smola Consulting is delighted to have the opportunity to contribute to the continued success of one of our clients.

Rochester’s Small Business National Philanthropy Award – November 2017


Steve Smola honored as 2017 Outstanding Small Business Philanthropist – Doing good things for the right reasons!

On National Philanthropy Day, The Association of Fundraising Professionals – Genesee Valley Chapter held their annual awards luncheon on Friday November 3, 2017. Mary Cariola Children’s Center, a Smola Consulting Client nominated Steve Smola for this wonderful award. Steve is the recipient of the Outstanding Small Business that demonstrates outstanding commitment through financial support and through encouragement and motivation of others to take leadership roles toward philanthropy and community involvement

Steve was honored and humbled to receive this award as his work with the Mary Cariola Children’s Center is a joy and rewarding in and of itself. Thank you to our extraordinary client and its leader, Karen Zandi for this nomination.

Annual Compliance Notice Summary

As the realm of compliance and regulations continues to get more complex each year, Smola Consulting is featuring this Benefits Bulletin that summarizes the annual employee compliance notice requirements, and the acceptable distribution method of employee notification.

The table below summarizes the five notices that must be made available to employees.

Annual Notice Frequency Distribution Method
Children’s Health Insurance Program Reauthorization Act (CHIPRA) Annual Paper or electronic
Medicare Creditable Coverage Annual (by 10/15 of each year) Paper or electronic
HIPAA Notice of Privacy Practices Upon enrollment and annually thereafter Paper or electronic
COBRA 1) New Employee Notification

2) COBRA “Participant” Notifications
1) Paper or electronic

2) Paper or electronic
(paper preferred)

Women’s Health and Cancer Rights (WHCRA) Upon enrollment and annually thereafter 1st notice – Paper or electronic
2nd notice – Must be paper

Specific requirements exist for providing notices through electronic communications. Compliance with these requirements is critical.

Conditions set forth below and in the Regulations for electronic disclosures must be satisfied. The individual who is the recipient of an electronic notice retains the right to obtain a paper copy of the notice from an employer upon request. Employers should always state on the electronic transmission that these documents are available in paper / written format, and can be requested through Human Resources. Individual employees covered by the plan who does not have access to employer intranet or e-mail must be provided the notice in paper format.

Additional information on electronic notices can be found through the Department of Labor at:
Regulation 29 CFR 2520.104b-l(c) & 2520.104b-l(c)(l)(iii)
Regulation 42 CFR 423.56(c)
Regulation 45 CFR 164.520(c)(3)

Model notices for CHIPRA, Medicare Creditable Coverage, HIPAA, COBRA and WHCRA can be found at:

Children’s Health Insurance Program Reauthorization Act (CHIPRA)
www.dol.gov/ebsa/chipmodelnotice.doc

Medicare Creditable Coverage
www.cms.gov

HIPAA Notice of Privacy Practices
http://www.hhs.gov/ocr/privacy/hipaa/modelnotices.html
http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/notice.html
http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf

COBRA
www.dol.gov/ebsa/modelelectionnotice.doc

Women’s Health and Cancer Rights (WHCRA)
www.dol.gov/ebsa/pdf/CAGAppC.pdf (pages 141-142)

This information does not constitute legal advice. Employers should consult their own legal counsel with respect to compliance with these laws.

Mary Cariola Children’s Center – 66th Annual Dinner – Smola Consulting is Presenting Sponsor

Smola Consulting is proud to be the presenting sponsor at the Mary Cariola Children’s Center Annual Dinner on May 21.

Smola Consulting Supports our Client and our Community – Lollypop Farm Telethon

LPF Teleihon 2015Smola Consulting participated in the 2015 Lollypop Farm Telethon – Tails of Hope – at Eastview Mall on March 7. Over $273,000 was raised to give a second chance to pets in need. The telethon was televised live on 13 WHAM ABC. Smola Consulting staff manned the phone bank speaking with generous contributors.

Smola Consulting donates over $15,000 annually to help save the lives of homeless and abused pets in our community. We proudly sponsor Lollypop Farm so they may provide veterinary intervention, food, shelter and compassionate care to pets in need.

It’s All About Caring for Kids! – IACKids

IAKids LogoSteve Smola, Board of Directors Treasurer for IACKids, believes it really is all about the kids. Smola Consulting was a title sponsor for the 2015 Open Your Hearts Gala Dinner held on March 7.  IACKids was founded in 2012 to help families in the greater Rochester region going through financial hardship due to their child’s severe illness.  Pediatric Social Workers at the Golisano Children’s Hospital help identify families in need. The 2015 gala raised over $100,000.

HHS Proposes 3rd Year Fee of $27 for ACA Transitional Reinsurance Program

On 11/21/2014, federal regulators proposed that insured and self-funded employers would have to pay $27 for each health plan enrollee in the third and final year of the Transitional Reinsurance Program, authorized by the Patient Protection and Affordable Care Act (PPACA). Self-funded employers pay this fee separately, where insured employers have this fee built into their rate.

The $27 fee, to be paid in 2017, has been proposed and is not final. It comes on top of an earlier disclosed $63-per-health-care-plan-participant fee that is to be paid next year, and a $44-per-participant fee that is to be paid in 2016.

The fees, whose amounts were set by the U.S. Department of Health and Human Services, are intended to generate $25 billion in revenues over a three-year period as set by the Patient Protection and Affordable Care Act, including $12 billion in the first year, $8 billion in the second year, and $5 billion in the third year.

The revenue generated by the program is to be used by the government to partially reimburse commercial insurers covering individuals with high health care costs.

Earlier, regulators said the 2014 fee could be paid in full with one $63-per-participant payment made by 1/15/2015. Alternatively, rather than pay the full $63 by 1/15/2015, employers could make a payment of $52.50 per participant by that date, with an additional $10.50-per-participant payment due 11/15/ 2015. Employers and health care plan sponsors also can choose between paying the 2015 and 2016 fees with one payment or with two payments.

The 2015 fee could be paid in full with one $44-per-participant payment made by 1/15/2016, or with a $33 payment made by that date, and an $11 payment made by 11/15/2016.

Similarly, the $27-per-participant fee for 2016 could be paid in full by 1/15/2017, or with a $21.60 payment made by that date, and a $5.40 payment made by 11/15/2017.

More information can be found at:
http://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/The-Transitional-Reinsurance-Program/Reinsurance-Contributions.html
http://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/The-Transitional-Reinsurance-Program/Downloads/Reinsurance-Contributions_Pay-gov-Form-Go-Live_10_17_14.pdf

Mary Cariola Children’s Center – 2014 Walking on Sunshine Event

MCCC Walking on Sunshine 2Smola Consulting was pleased to participate in 2014 Walking on Sunshine Event held at Ontario Beach Park on September 28 . The Smola Consulting team staffed the auction tent. Over 1,400 people took part in the walk. Mary Cariola surpassed their goal of $135,000 by raising nearly $149,000! Smola Consulting is proud to support the youth that Mary Cariola serves.

Affordable Care Act Employer Mandate Delayed – Redefined

Employers with 50-99 Full-Time Workers – Delayed Coverage Offering Until 2016

Employers with 100 or More Full-Time Workers – Mandate Changes From Offering Coverage to 95% of Employees to 70%

On February 10, 2014, the IRS and Treasury Department issued final regulations that impact enforcement of the Employer Mandate. Two changes were announced – one impacting employers with 50-99 employees, and the other with greater than 100 employees.

Employers with 50-99 full-time workers workers will be given until 2016 to offer health insurance coverage to employees before they risk a federal penalty for not complying.

Employers with 100 or more full-time employees will be subject to the mandate starting in 2015, although coverage to eligible full-time employees is reduced from 95% to 70% in 2015 to avoid the Type A penalty. Employers will need to offer coverage to at least 95% of eligible employees in 2016 to avoid the Type A penalty.

Clarification was provided for employers with a plan year which doesn’t start on January 1. The mandate was previously unclear when the penalty would apply – on January 1, 2015 or on the first day of the plan year (if not January 1). For employers with 100 or more full-time employees, the mandate will apply on the first day of their plan year in 2015 (meaning employers with non-calendar year plans will not have to provide coverage to full-time employees on January 1, 2015; coverage must be provided as of the first day of the plan year starting in 2015).

One additional clarification was provided regarding the length of the measurement period. In 2014, a shortened transition measurement period of six months is permitted.

The full-time employee definition remains at 30 hours or more per week. The definition of dependent has been revised to exclude stepchildren and foster children, and continues to exclude spouses.

More information can be found at:
http://www.treasury.gov/press-center/press-releases/Pages/jl2290.aspx/
http://www.treasury.gov/press-center/press-releases/Documents/Fact%20Sheet%20021014.pdf
http://www.ofr.gov/OFRUpload/OFRData/2014-03082_PI.pdf

FSA Plans – “Use It or Lose It” Provision Amended

The IRS issued Notice 2013-71 on October 31, 2013, which now allows up to $500 of unused funds in Flexible Spending Accounts to be carried over to the next plan year. This change can be effective to plan years beginning in 2013 and after, as long as you amend your plan document accordingly.

On December 31st of this year, “use it or lose it” will only apply to dollars $501 and above. The rollover can be $500, or any lesser amount. Employers can set a lower rollover amount, but it must make that same rollover limit available to all eligible plan participants.

This change is at the employer’s discretion. The FSA medical limits remain the same at $2,500. However, up to $3,000 may be available in the following plan year if the participant were to rollover the full $500 the prior year.

An employer can only implement this new rollover option if the plan does not include a grace period. If a grace period currently exists, it must be removed before the new rollover option is implemented.

This new amendment will require a plan document amendment. Amendments to remove the grace period, if applicable, and to adopt the rollover provision, must be adopted on or before the last day of the plan year from which amounts may be rolled over.

More information can be found here.

Smola Consulting Client Wins 2013 Wealth of Health Award – Finger Lakes Area School Health Plan

FLASHP W of H 2014The Finger Lakes Area School Health Plan school consortium – comprised of 37 school districts in Livingston, Ontario, Wayne, Seneca and Yates counties – was recognized as a leader in promoting worksite wellness within their school districts. The FLASHP consortium has an active wellness committee – Wellness is Now (WIN) – has done a fantastic job promoting health and wellness throughout the consortium. WIN has developed ways health and wellness can be incorporated into the daily lives of employees. They provide resources, education and programs to benefit employee health. Their hard work and dedication to wellness earned them the large employer 2013 Wealth of Health Award!

 

Employment Based Wellness Programs Final PPACA Regulations

The Department of Health and Human Services (HHS) issued final Patient Protection and Affordable Care Act (PPACA) Health Care Reform rules on May 29th, 2013 regarding employment based wellness programs.  The final regulations increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan from 20% to 30% of the cost of coverage, and to 50% when the wellness program is designed to prevent or reduce tobacco usage.  The final rules will be effective for plan years beginning on or after January 1, 2014.

The final rules support workplace health promotion and prevention without regard to an employee’s current health status.  These Health Care Reform rules expand non-discrimination protections for employer-sponsored wellness programs.  The final rules also provide more clearly defined guidelines to design and implement workplace wellness programs than were in HHS’s initial proposal.

The final rules include standards for both participatory wellness programs (those available without regard to an individual’s health status such as rewards to employees for taking a health risk assessment, or participating in a biometric screening, etc), and wellness programs that have “health contingent wellness programs” (those which reward individuals for meeting a specific health standard such as no tobacco usage, having a specified cholesterol level, etc).

References in the final regulations include rewards such as:

  • Discount or rebate of a premium or contribution;
  • Waiver of all or part of a cost-sharing mechanism (such as a deductible, copayment, or coinsurance);
  • Additional benefit, or any financial or other incentive;
  • Avoiding a penalty, such as the absence of a surcharge or other financial or nonfinancial.

The final rules state:

  • Individuals eligible for the program must be given an opportunity to qualify for the reward at least once per year;
  • The size of the award reward offered to an individual under all health-contingent wellness programs with respect to a plan cannot exceed the applicable percentage of employee-only coverage under the plan, taking into account both employer and employee contributions towards the cost of coverage for the benefit package under which the employee is receiving coverage.  If, in addition to employees, any class of dependents (such as spouses or dependent children) participate in the health-contingent wellness program, the reward cannot exceed the applicable percentage of the total cost of the coverage in which the employee and any dependents are enrolled or employee-plus-one coverage;
  • The reward for a health-contingent wellness program, together with the reward for other health-contingent wellness programs with respect to the plan, must not exceed 30% of the total cost of employee-only coverage under the plan, or 50% to the extent the program is designed to prevent or reduce tobacco use;
  • Consumers are protected with the following provisions:
    • Wellness programs must be reasonably designed to promote health or prevent disease;
    • The full reward under a health-contingent wellness program must be available to all similarly situated individuals;
    • Recommendations be accommodated which are made at any time by an individual’s physician based on medical appropriateness.

To read the final rules in their entirety, please visithttp://www.ofr.gov/OFRUpload/OFRData/2013-12916_PI.pdf

Employer Penalties Delayed

On July 2, 2013, the Treasury Department announced a one year delay in the employer mandate which penalizes employers with more than 50 employees for not providing a minimum level of affordable health insurance. Originally the penalty was to be effective starting in 2014. However, these penalties have officially been delayed until 2015.

According to the Treasury Department’s announcement (http://www.treasury.gov/ connect/blog/Pages/Continuing-to-Implement-the-ACA-in-a-Careful-Thoughtful-Manner-.aspx):
This is designed to meet two goals. First, it will allow us to consider ways to simplify the new reporting requirements consistent with the law. Second, it will provide time to adapt health coverage and reporting systems while employers are moving toward making health coverage affordable and accessible for their employees.

The individual mandate is unaffected by the rule change, requiring most Americans to purchase insurance or pay a penalty, with tax credits provided to those who can’t afford coverage. Also unaffected is the establishment of exchanges in states for low-income Americans to obtain health insurance.

More information can be found at:
http://www.treasury.gov/connect/blog/Pages/Continuing-to-Implement-the-ACA-in-a-Careful-Thoughtful-Manner-.aspx

We will continue to keep you informed as more information becomes available.

Employer Notice of Coverage Options

As a requirement of the Patient Protection and Affordable Care Act (PPACA), all employers with over $500,000 in annual revenue are required to notify all employees about their healthcare options available through the Health Insurance Exchanges. This Benefits Bulletin addresses the temporary guidance of this notification that was issued on May 8, 2013.

Employers are not yet required to provide notices under this temporary guidance, and can wait until formal guidance is provided later this year.

This notification is called the Employer Notice of Coverage Options, and a template is located at http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf. Originally scheduled for March 1, 2013, this notice deadline has been delayed until October 1, 2013 to coincide with the beginning of the Health Insurance Marketplace (Exchange) open enrollment period.