Hamilton Headlines
May 2, 2016

Program Update Continue

Protocol - Current

The OCR HIPAA Audit program analyzes processes, controls, and policies of selected covered entities pursuant to the HITECH Act audit mandate. OCR established a comprehensive audit protocol that contains the requirements to be assessed through these performance audits. The entire audit protocol is organized around modules, representing separate elements of privacy, security, and
breach notification. The combination of these multiple requirements may vary based on the type of covered entity selected for review.
  • The audit protocol covers Privacy Rule requirements for (1) notice of privacy practices for PHI, (2) rights to request privacy protection for PHI, (3) access of individuals to PHI, (4) administrative requirements, (5) uses and disclosures of PHI, (6) amendment of PHI, and (7) accounting of disclosures.
  • The protocol covers Security Rule requirements for administrative, physical, and technical safeguards.
  • The protocol covers requirements for the Breach Notification Rule.
The protocol is available for public review and searchable by keyword(s).

Please note the protocol has been updated to reflect the Omnibus Final Rule. You may submit feedback about the audit protocol to OCR at OSOCRAudit@hhs.gov.
Full Protocol
10 Mistakes That Could Trigger a 401(k) Plan Audit

Benefit professionals, at a minimum, should take the time now to sit down with outside ERISA counsel and plan an internal audit to ensure that their plans are in compliance, says Heidi L. Lamarca, a principal and practice leader of Windham Brannon, a chartered professional accounting firm. She outlines 10 red-flag risk areas that often draw the DOL's attention and could trigger an audit of your 401(k) plan.

1. Missteps with the plan's eligibility requirements
Some employees may be enrolled too early or too late-or forgotten altogether, which can be the case with employees working at another corporate affiliate or division.

  2. Misinterpretation of vesting period  
Each plan defines when employees reach one year of service. HR and other departments may calculate it differently.

3. Violation of break-in-service rules  
Usually, plans state that when employees leave and are rehired within a certain time frame, that they're automatically eligible to participate in a 401(k) plan. This rule is sometimes overlooked.

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Guide to FMLA

The Department of Labor released  the Employer's Guide to FMLA in an effort to increase public awareness of the FMLA and of the various Departmental resources and services available to the public. It is very detailed and is over 70 pages in length.
For a copy of the guide, please click on the link below :

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HIPAA Audit Program Update:

Audit Pre-Screening Questionnaire 
The questionnaire is made up of 4 parts: Instructions, Contact/Entity Info, Questions, Review & Submit.

If you are unable to complete the questionnaire in its entirety, you can [SAVE] your responses and complete the questionnaire at a later time using the link that was provided in the email notification. Once [Submit] has been selected, you will not be able to re-access the questionnaire.

Contact/Entity Type - Please review and update as needed. All fields are required. If all fields are not completed before clicking [Continue] or the Questionnaire tab the system will display at the top of the screen a list of the missing information.

Questionnaire - A response is required for all questions. If all fields are not completed before clicking [Review and Submit] the system will display at the top of the screen a list of the missing information.

Review & Submit - The system will display all questions with your responses. Scroll to the bottom to select [Print] to retain a copy of your responses. To change a response, click the Questionnaire tab at the top of the screen. Click [Submit] to submit your responses. Once submitted, access to the questionnaire is no longer available.

Basic Description Information About Your Organization

Question 1: Entity is:
Answer Choices:
  • Public
  • Private
Views Employers Advised to Review Employee Classifications 

Whether you are an employer trying to decide whether to hire an employee, or a professional thinking about which option is the best for you, the IRS has guidelines defining each category.

Independent contractors offer their services to the general public and typically have an independent trade or business such as doctors, lawyers, accountants, contractors, etc. The payer has the right to control or direct the result of the work but not what will be done or how it will be done. Contractors often have a significant investment in the facilities or equipment he or she uses in performing services. Earnings are subject to self-employment tax. Generally, an employer does not have to withhold or pay any taxes on payments to independent contractors.

Employees are anyone who performs services for you if you can control what will be done and how it will be done. The employer has the right to control the details of how the services are performed. Generally, employers must withhold income taxes, withhold and pay Social Security and Medicare taxes and pay unemployment tax on wages paid to an employer.

Full Article 
IRS sets 2017 HSA Contribution Limits  

The Internal Revenue Service announced Thursday that the maximum contribution that can be made next year to an HSA linked to a high-deductible plan will be $3,400, up from $3,350, while the maximum contribution for those with family coverage will remain at $6,750.

However, maximum out-of-pocket expenses will remain the same in 2017 for both categories.

The maximum out-of-pocket employee expense, including deductibles, will remain at $6,550 for single coverage, and $13,100 for family coverage.

For 2017, a high-deductible health plan is defined as a one with an annual deductible of least $1,300 for self-only coverage and $2,600 for family coverage.
ACA Reporting Requirements:
Forms 1094-C and 1095-C to be filed with the IRS by May 31, 2016 (instead of February 29, 2016) or June 30, 2016 (instead of March 31, 2016), if filing electronically.  
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Please note that Hamilton Insurance does not provide legal advice, and this does not constitute advice of any kind for any 
particular situation. Instead, this is intended as non-comprehensive general information serving as a starting point for further 
discussion. Please contact your tax and/or legal advisors for information about how these issues affect you.  
About Us
H amilton Insurance , a top ranked independent broker in the Washington DC/Metropolitan Area and the nation, has over 35 years of experience in providing insurance brokerage, risk management and employee benefit solutions. It represents a full suite of commercial, health & welfare, and personal insurance solutions, supported by risk compliance and group benefit administrative services. 

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