Women’s Health and Cancer Rights Act

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The Women’s Health and Cancer Rights Act was a major turning point for women suffering from breast cancer and other cancers that require mastectomies. Under this Act, there are protections for patients who elect breast reconstruction in connection with a mastectomy. For plan participants and beneficiaries receiving benefits in connection with a mastectomy, plans offering coverage for a mastectomy must also cover reconstructive surgery and other benefits related to a mastectomy.

Who does it apply to?

  • Group health plans for plan years starting on or after October 21, 1998
  • Group health plans, health insurance companies or HMOs, if the plan or coverage provides medical and surgical benefits with respect to a mastectomy
  • Requires coverage for reconstructive surgery in a manner determined in consultation with the attending physician and the patient

What does it cover?

  • Reconstruction of the breast on which the mastectomy was performed
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance
  • Prostheses and physical complications at all stages of mastectomy, including lymphedemas

What else do I need to know?

Under WHCRA, mastectomy benefits may be subject to annual deductibles and coinsurance consistent with those established for other benefits under the plan or coverage. Additionally, plans and issuers denying eligibility or future eligibility to enroll or renew insurance coverage are prohibited. They cannot penalize or provide incentives to physicians for providing care that is inconsistent with the WHCRA requirements.

Maintaining compliance with this regulation requires a deep understanding of the types of insurance plans offered to your employees as well as their individual coverages and policies. Benefits are consistently changing and compliance with such benefits can be challenging. A PEO specializes in doing just that – finding the best benefits and keeping up with regulatory compliance. Do you want to make your HR administrative responsibilities easier?

Contact us today to get set up with a PEO who can go to work for you!

The Mental Health Parity Act

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What is the Mental Health Parity Act? According to the Department of Labor’s website, “The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits. MHPAEA supplements prior provisions under the Mental Health Parity Act of 1996 (MHPA), which required parity with respect to aggregate lifetime and annual dollar limits for mental health benefits.”

Essentially this act seeks to require parity between the coverage of standard medical conditions with mental health and addiction issues. Typically, mental health services as well as addiction services and support were either not covered or had very low insurance coverage. The revision to the act supplements the existing Parity Act, passed in 1996.

Mental health and addiction are prevalent and growing issues in America and as such, the support and care for them is a hot issue. With the implementation of the Affordable Care Act, there have been additional requirements that need to be fulfilled by businesses depending on their size, benefits structure and number of employees.

These regulations are not just complex at their basis but also are dynamic. They are updated regularly and as such, employers need to make sure that they are monitoring regulatory shifts. Not only is this confusing but it’s also time consuming, particularly for small to medium businesses who are sometimes exempt or required to follow separate legislation.

Feeling overwhelmed with compliance? That is where a PEO comes in. PEOs are experts in these areas and have dedicated staff to track and monitor changes and subsequently managed the implementation of changes in business process to maintain compliance. Contact us today to find a PEO who can help you stay in touch and in regulation!

 

Purpose of an EIN

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An Employer Identification Number (EIN) is essentially a Social Security Number for your business. EINs are used to distinguish your business financial data from your personal finances.

Who Needs an EIN?
These 9 digit numbers are utilized for tax purposes and are required for every business with one or more part-time or full-time employees. Additionally, if you pay any contractor or subcontractor for services valued at more than $600 per calendar year, you are also required to have an EIN. If you are registered as a limited liability company, corporation, partnership, or joint venture then you must have an EIN.

How does an EIN work?

EINs identify the business entity and are tagged to all employees as well. These numbers are utilized by employees when filing tax returns and relevant tax documents. The government tracks revenues, salaries and other financial data utilizing these numbers.

How do I obtain an EIN?

Your PEO can assist you in obtaining an EIN or you can apply for one online from the IRS. Online EINs are effective immediately. Additional application options include applying by fax or by mail. Regardless of your application method, it takes up to two weeks for the IRS to assign your EIN to their database.

One of the benefits of outsourcing your HR functions to a PEO provider is that they are capable of handling all of the tricky tax codes and payroll processing services. Contact us today to find out more about how a PEO can help you optimize your payroll and tax processes.

 

Why Do I Need a PEO?

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As we mentioned in a recent blog, utilizing a PEO allows a business owner to focus on their key business functions. Particularly with small to medium sized businesses where your headcount is lower, utilizing a PEO is a great way to optimize your business processes without significantly increasing costs.

One of the key benefits to utilizing a PEO is that they are specialists in all things Human Resources Related. From benefits to compliance to billing – their job is to not only to understand the current requirements but also support future changes to regulations. Some of the functions that PEOs support include:

  • Employment administration
  • Government compliance management
  • Employee benefits
  • Workers’ compensation
  • Payroll and payroll tax administration
  • Recruiting and hiring
  • Policies and best practices
  • Performance management
  • Training and development

If you find that you are spending a significant portion of your time or working extra hours to make payroll happen or recruit new employees you should seriously consider utilizing a PEO. Another great reason to engage a PEO is if you are a new business owner. They can help you set up your human resources processes including training and development and performance management. We find that with a lot of new and expanding businesses a lot of human resources processes are left to a trial by fire methodology. PEOs exist to reduce your administrative stress, increase your compliance and optimize your business processes at an affordable cost.

Contact us today for a consultation around what PEO services can help you succeed as a business!

How Can a PEO Fit Into My Organization?

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A PEO (Professional Employer Organization) steps in and provides an affordable, holistic management services to support your company’s human resource functions. PEOs are unique in that they offer a full suite of services, unlike companies who offer specific services like benefits or payroll administration. PEOs functions offer a broad range of HR-related services such as employment administration, recruiting, workers’ compensation insurance, employee benefits, payroll, compliance, best practices, employee training, and performance management.

PEOs are ideal business partners as they allow you to choose what they help you with. Whether you are looking to entirely outsource all of your administrative functions or simply bulk up your worksite OSHA compliance – PEOs can support you. It is important to remember that at the very minimum, a PEO must provide their clients with payroll and workers’ compensation insurance. Given their expertise in the areas of Human Resources and Compliance, they not only absorb the work but also the risk.

The term Co-employment is often used when referring to PEOs. What this indicates is the separation of human resources, employee management and liabilities that occur when you work with a PEO. Co-employment is a unique business model as it requires that your employees work for both you and the PEO. Standard daily business operations are supported by your team, but the PEO assumes all administrative functions. As such, the PEO shares many of the liabilities associated with your business and employees.

PEOs serve as an extension of your business that handle Human Resources, leaving you as a business owner to focus on what truly matters – the current and future success of your operation.

Contact us today to find out how we can make PEO services work for you!