Keeping You Current
 July 2015 Monthly Newsletter
A list of the challenges business owners and managers face often seems never ending. At the top of the list for many are HR related issues including of course, benefits. Answering questions, finding solutions and preventing problems is what we do at Benefits Done Right. Let us help you. 

This month's updates cover some very important decisions that will affect your business. Please take a few minutes to read through them and as always, contact us directly for more information.     
  1. Marriage Equality: Health Insurance Impact
  2. Insurance Carriers Get Set to Comply With ACA Reporting Requirements
  3. U.S. Supreme Court Upholds Premium Tax Credits in Federal Exchanges
  4. SEAC August Workshop: When An Employee Complains
The Supreme Court Decision on Same-Sex Marriage - How it Will Affect Health Insurance Decisions

The Supreme Court decision overturning state bans on same-sex marriage will have implications for the employer-based benefits system. The 5-4 decision in Obergefell v. Hodges determined that marriage, regardless of sexual orientation, is a fundamental right under the Constitution's Equal Protection Clause and states do not have a right to deny marriage to same-sex unions. Prior to the decision, same-sex marriage had been legalized in 37 states.  


The most important thing about the ruling for BDR client's to understand is that now there will be standardization across the country for how employers treat employees for spousal benefits. Previously, employers had to navigate a complicated patchwork of laws across states to determine whether benefits would need to be extended to same-sex spouses. The ruling, which is effective immediately, will help to clear up some of the confusion for employers uncertain of whether they legally need to offer coverage to same-sex spouses. It will also help to clear up confusing plan administration for some domestic partnership couples who could now become legal spouses.

A Kaiser Family Foundation survey last year found that while nearly all employers offered coverage to spouses, only half allowed same-sex partners to claim insurance benefits if they weren't legally married. The ruling could lead to some employers dropping coverage for domestic partnerships and instead only offering to legally wed spouses.

The Supreme Court ruling will also force changes for Medicaid and the health insurance marketplaces. The 2013 ruling that struck down the Defense of Marriage Act led CMS to encourage states to recognize same-sex marriages performed in another state when the state the couple resides does not recognize same-sex marriage, leading to a gray area in how benefits would be applied. This ruling will require all states' Medicaid programs to recognize all legally wed spouses. The decision will also impact same-sex households applying for tax credits on the exchanges, where they may previously have been treated as individuals but can now apply as a married couple.


Source: National Association of Health Underwriters

Insurance Carriers ACA Reporting Requirements      
May Be Asking for Employee Personal Information           

In compliance with reporting requirements under the federal Affordable Care Act, insurance carriers must report all insured's social security numbers to the IRS. Carriers have started reaching out to all employees with group coverage to collect this information if it has not already been made provided to them. This is a great opportunity for SCAM artists so please encourage your employees to verify the source of the request and or reach out to your BDR Account Manager for verification before providing any personal information.


The law requires all insurance carriers to supply the IRS with key information on each covered individual. This information includes, but is not limited to name, social security number (SSN) or taxpayer identification number (TIN) and the months in which a member had coverage. In addition, each plan subscriber must be sent a form 10956-B statement reflecting medical coverage held for themselves and their dependents, which will be used when filing their 2015 tax return. Employers do not have reporting responsibilities for the 1095-B if they are fully insured. (Different rules for self-insured groups). The carriers will be sending this information to the IRS.

In addition, each subscriber must be sent a form 1095-B statement reflecting medical coverage held for themselves and their dependents which will be used when filing their 2015 tax return.

For more information on these new requirements, you may visit the IRS website at

U.S. Supreme Court Upholds Premium Tax Credits in Federal Exchanges    
Premium Tax Credits Will Be Available to Individuals Enrolled in Federal or State-Based Exchanges          

The U.S. Supreme Court has ruled that the Affordable Care Act's premium tax credits are available to eligible individuals who enroll in qualified health plans through any health insurance exchange (marketplace), regardless of whether it is a state-based exchange or a federally-facilitated exchange.


Although this was not an immediate concern for states like California that offered an exchange, the outcome on a federal level could impact all states and lead to further waste in legislation of tax payers dollars. Regardless of whether you agree or disagree with the ruling, this decision means we can all move on.


The IRS is expected to provide updates regarding this matter soon.


When an Employee Complains     

There are many challenges when running a company, the least of which are handling HR issues and keeping employees happy and productive. Laurie accepted the board position with SEAC, the Sacramento Employer Advisory Council due to the incredible value that is provided for all members. SEAC is a non-profit and supported by the EDD. Their workshops and seminars always feature top local attorneys who are experts in their area of practice.


We invite you to attend their next event on Wednesday, August 19, "When an Employee Complains: Strategies for Avoiding and Responding to Retaliation and Wrongful Termination Claims." This informative workshop will cover topics including: The prevention of complaints through the effective use of policies and sound management practices; Responding to employee complaints and managing the work environment following a complaint; Addressing performance problems of complaining employees, and disciplining and terminating employees following a complaint; and Preparing for and responding to complaints to administrative agencies and legal actions. 


The workshop begins with breakfast and networking starting at 7:30 a.m. with the workshop wrapping up at 12:30 p.m. at the Sac State Alumni Center in Sacramento. Click here to register for the event or contact for more information.

Benefits Done Right Insurance Agency, Inc.
601 University Avenue, Suite 250 / Sacramento, CA  95825
800-482-1817 / 916-568-2345 / fax: 916-564-9228

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