News

Apr 30 2020

United Healthcare Expands Telehealth Options

Talk to a doctor from home

Telehealth gives you access to health care providers from the comfort of your home. You can use digital audio-visual technologies, like FaceTime, Skype, Zoom or telehealth applications for your visit. We expanded access to telehealth to help you stay in your home and reduce exposure to the virus.

If you think you might have been exposed to COVID-19 or have symptoms such as fever, cough or difficulty breathing, be sure to call your doctor right away.

Let’s review your telehealth options

Many health care providers may be able to provide a telehealth visit. You can schedule telehealth visits for COVID-19 testing or concerns. It also might be a great option if you need care for other health needs. This way, you can stay at home while still getting the care you need.

Telehealth visits for 24/7 urgent care

Virtual Visits are a way to talk with a health care provider online for urgent care needs, 24/7. These visits are available through our preferred telehealth partners, including Teladoc, American Well, Doctor On Demand and other partners. These visits are ideal for urgent care, like seasonal flu, allergies, pinkeye and more.

Medicare Advantage and Medicaid members can continue to access their existing telehealth benefit offered through one of our designated partners without cost-sharing. For members with a telehealth benefit through their employer-sponsored plan, cost-sharing will be waived until June 18, 2020. Sign in to your health plan account to review your telehealth benefit.

Telehealth visits with your local providers

You can ask your local health care provider if they can provide a telehealth visit. If you don’t have a doctor you see regularly, you can sign in to your health plan account to find a network provider that may be able to offer a telehealth visit. Sign in to your account to find a provider.

Below, you’ll find your care options and coverage details for telehealth visits with your local provider.

Routine medical care visits

If you have other care needs, you may be able to schedule a telehealth visit with your local health care provider for both urgent and non-urgent needs. These visits can be for any of the following:

Urgent care or routine medical care (interactive audio/video and audio-only)
Outpatient behavioral care (interactive audio/video and audio-only)
Physical, occupational or speech therapies (interactive audio/visual only)

Cost-sharing is waived for in-network telehealth visits from March 31, 2020, until June 18, 2020, for members with Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans. We will work with self-funded customers who want us to implement a similar approach. Out-of-network and cost-sharing will apply, if applicable. Out-of-network telehealth services will be covered in accordance with your health plan benefits.

COVID-19 testing-related visit

If you need to schedule a visit for COVID-19 symptoms, telehealth may be a good choice. You can talk with your provider in the comfort of home. We’ve waived cost-sharing for a COVID-19 testing-related visit during this national emergency. This coverage applies to Medicare Advantage, Medicaid, Individual and Group Market health plans.

Apr 30 2020

FAQs for Section 125 Plan Changes Amid COVID19

Niels Christiansen has served as President and Owner of ABY Benefits, LLC, a DFW based TPA for the alphabet soup of the tax code, for more than 10 years. He graduated from Regis University in Denver, CO with a Master’s Degree in Operations Management and International Business, and in 2018, he completed his SPHR certification. Niels has led ABY to exponential growth through a combination new business sales, multiple mergers and acquisitions as well out of the box thinking and new product development.

Niels and ABY’s focus is to help promote easy to understand benefit compliance as it relates to Section 125 POP/FSA, Section 105 HRA, Section 132 Qualified Transit Benefits, HSA, ERISA and COBRA plans.

Q: Can an Employer allow Section 125 election changes amid COVID19?

A: While no new guidance from the IRS regarding election changes, however there are several statues allowing for changes. In order for a change to made, a Qualifying Event (QE) must have taken place. The first place to look for allowable QEs is the Plan Document governing the plan.

Q: What is considered a Qualifying Event under Section 125?

A: The IRS standard QEs include: • Defined in Plan Document – updates allowed o Eligibility / rehire requirements o FSA / Daycare claim submission periods • Birth / death / adoption / marriage / divorce • Reduction in hours / significant pay change • Significant cost change • Termination / layoff / furloughs / job change • Spousal / exchange open enrollment

Q: Is COVID19 a QE under Section 125?

A: The mere presence of OR contracting COVID19 is not QE under Section 125, however much of the fallout from will lead to a QE. For example, employees experiencing a layoff or reduction in hours or children no longer being allowed to attend schools may have experienced a QE allowing for certain election changes. Many insurance carriers are allowing special enrollment periods, but this is not a QE under Section 125.

Q: What elections can be changed?

A: Most pretax deductions may be changed if you experience a true QE and those changes must be consistent with the QE. Changes can include premium deductions, Daycare FSA deductions, Qualified Transit Benefit deductions and in very limited cases Medical FSA deductions. As before, HSA deductions may also be changed.

Q: What insurance premiums can be changed?

A: If due to a true QE, an employee adds, drops or changes coverage, pretax insurance premium deductions can be added, changed or stopped. If due to a carrier special enrollment period amid COVID19, an employee adds, drops or changes coverage, pretax insurance premium deductions CANNOT change. This includes premium for newly enrolling a spouse or dependent.

Q: When can Daycare and Medical FSA election be changed because of COVID19?

A: With Daycare FSA, there several QEs created as a result of COVID19. A large number of schools and daycare providers are closed, which creates a significant cost change for parents as does a reduction of hours or partial furlough or layoff, all of which then allows for election changes. On the other hand, Medical FSA deductions are not as simple and it seems that without more clear guidance, making changes is not allowed. Some QEs may apply but in general, Medical FSA elections cannot be changed due to COVID19.

Q: When can Qualified Transit Benefit election changes be made?

A: The section 132 Qualified Transit Benefit (QTB) elections can be changed with a QE such as a significant cost change as a result of the stay at / work from home orders or at the end of the Plan Period, which is typically a calendar month and is defined in the Plan Document. Making changes to QTB deductions due to COVID19 is very simple.

Q: Are over-the-counter and Feminine Hygiene now FSA and HSA eligible?

A: For both FSA and HSA, over-the-counter (OTC) items and feminine hygiene products are now fully eligible items effective January 1, 2020. ABY is ready to accept and process all OTC and feminine hygiene claims immediately and we anticipate Debit Cards to be ready within the next few weeks. It has been suggested by SIGIS, the entity responsible for coding eligible items, that the more than 19,000 new items will be ready midApril. Your FSA and HSA debit card will accept these new items as soon as SIGIS and eligible merchants make the update to their systems.

Apr 14 2020

Family First Response Coronavirus Act Tax Credits (FFCRA): Paid Sick and Family Leave

Eligibility

Business with fewer than 500 employees who are required to provide additional paid sick and family leave due to the FFCRA

Leave Qualifications

1. Employee is under quarantine related to COVID-19

2. Employee has been advised to self-quarantine COVID-19

3. Employee is experiencing symptoms of COVID-19

4. Employee is caring for an individual in quarantine

5. Employee is caring for the child if the school or place of care closed due to COVID–19

6. Employee is experiencing any other substantially similar condition specified by the U.S. Department of Health and Human Services

Credit Amount

Fully refundable tax credit equal to the required paid family and medical leave for the period 4/1/2020 – 12/31/2020:

– For conditions 1,2,3 – paid sick leave for up to 80 hours at the employee’s regular rate of pay, or, if higher, the Federal minimum wage or any applicable State or local minimum wage, up to $511 per day and $5,110 in the aggregate

– For conditions 4,5,6 – paid sick leave for up to two weeks (up to 80 hours) at 2/3 the employee’s regular rate of pay or, if higher, the Federal minimum wage or any applicable State or local minimum wage, up to $200 per day and $2,000 in the aggregate

Special Considerations

Credit includes employer’s share of Medicare tax & cost of maintaining health insurance coverage for the employee during the leave period

Wage Exclusions

Wages associated with employee retention credit are not eligible as refundable amounts for paid sick leave credit

*Employers can apply both FFCRA and Employee Retention credits, but the credits cannot apply to the same wages paid by the employer

Effect on Other SBA Loans

PPP Loan forgiveness will be reduced by tax credit amounts

How to receive the credit

Eligible Employers will be able to retain an amount of all federal employment taxes equal to the amount of the qualified leave wages paid, plus the allocable qualified health plan expenses and the amount of the employer’s share of Medicare tax imposed on those wages, rather than depositing them with the IRS.

Employers can file Form 7200, Advance of Employer Credits Due To COVID-19, to claim an advance credit instead of retaining amounts

Documentation Requirements

Must retain records and documentation supporting each employee’s leave to substantiate the claim for the credits, as well retaining the Forms 941

Employee Retention Credit

Eligibility

Any employer (all corporations, pass through entities and sole proprietors), regardless of size that:

Fully or partially suspended operations due to governmental order related to Covid-19

Experienced revenue loss of 50% or more in the same quarter as compared to 2019 (no longer qualify when receipts go above 80% of comparable quarter)

*Also applies to tax exempt organizations that meet item 1.

Credit Amount

50% of qualified wages paid by the employer for the period 3/13/2020 – 12/31/2020

*Qualified wages for all calendar quarters in 2020 cannot exceed $10,000 per employee

– Employers with more than 100 full-time employees, qualified wages include wages paid to employees when they are not providing services due to a governmental order related to COVID-19.

– For eligible employers with 100 or fewer full-time employees, all employee wages qualify for the credit, whether or not the employee is providing services to the employer.

Limitations

If an employee is performing services on a reduced schedule, qualified wages may not exceed the amount the employee would have been paid for working an equivalent period

*Qualified wages do include certain healthcare costs paid by an employer to maintain a group health plan

Wage Exclusions

Wages associated with the FFCRA credit are not eligible as qualified wages for the employee retention credit

*Employers can apply both credits, but the credits cannot apply to the same wages paid by the employer

Effect on Other SBA Loans

Employers cannot get both a small business loan under the PPP and also claim a tax credit

How to receive the credit

Eligible Employers can be immediately reimbursed for the credit by reducing their required deposits of payroll taxes that have been withheld from employees’ wages by the amount of the credit.

If an employer’s tax deposits are not sufficient to cover the credit, form 7200, Advance Payment of Employer Credits Due to Covid-19, may be submitted

Documentation Requirements

Report total qualified wages and the related health insurance costs for each quarter on quarterly employment tax returns or Form 941 beginning with the second quarter.

Payroll Tax Deferral

The CARES Act allows for employers and self-employed individuals to defer the payment of the employer portion of the Social Security payroll taxes made after 3/12/2020 through 12/31/2020. All employers and self-employed individuals are eligible with the exception of those that have had a debt forgiven under the Payroll Protection Program. Remittance of deferred taxes can be done in two equal installments with 50% due on 12/31/2021 and the remaining 50% due on 12/31/2022. Employers should work with their payroll service provider to immediately begin deferrals.

We at Lovelace Payne are committed to bringing you the most relevant and up to date information in an effort to help your business stay on track during this period of uncertainty. Please note that not all provisions, exceptions, exclusions, and special circumstances are included in order to maintain brevity. Please reach out directly so that we can provide the business support you need in these unprecedented times. We are here for you, contact us today at wecare@lovelacepayne.com or 972-629-9164.

John Payne	Terry Lovelace	Caitlin LeMaire	Ross Pasekoff

Dallas office:

Fort Worth office:

16610 North Dallas Parkway Suite 2700

Dallas, TX 75248

1635 Rogers Road

Fort Worth, TX 76107

Treasury Circular 230 Disclosure – To comply with requirements imposed by the Internal Revenue Service, we inform you that any tax advice contained in this written communication (including any attachment) is not intended or written to be used, and cannot be used, by any person for the purpose of avoiding tax penalties that may be imposed on the person. If this written communication contains any tax advice that is used or referred to in connection with the promoting, marketing or recommending of any transaction(s) or matter(s), this written communication should not be construed as written to support the promoting, marketing or recommending of the transaction(s) or matter(s) addressed by this written communication, and the taxpayer should seek advice based on the taxpayer’s particular circumstances from an independent tax advisor. No limitation has been imposed on disclosure of the tax treatment or tax structure of the transaction(s) or matter(s).

Apr 04 2020

Payroll Protection Program vs. Economic Injury Disaster Loan: What you need to know.

Legacy Benefits is happy to welcome contributions from John Payne of TJ Advisors.

John is a Founding Partner of both TJ Advisors and the accounting firm Lovelace Payne.

TJ Advisors LLC is a full service CPA firm founded in 2016 to provide assurance and advisory services in conjunction with tax services provided through our affiliated firm, Lovelace Payne LLC. Our commitment to quality, service and value are key elements in our early success. Our firm was founded on the principle that we must create more value than we charge in fees. We understand that timely communication with clients and delivery of our services in a timely manner is critical to our sustained success.

Economic Injury Disaster Loan As expanded by the CARES Act	Payroll Protection Program
Who is eligible?
• A business, ESOP, cooperative, or tribal small business concern with less than 500 employees • Sole proprietors and independent contractors • Private nonprofit organizations • Small agricultural cooperatives AND • In operation at January 31, 2020	• Businesses, nonprofits organizations, veterans organizations, tribal business concern with less than 500 employees. (Certain industries may have more than 500 employees) • Sole proprietors, Independent contractors and eligible self-employed individuals AND • In operation at February 15, 2020
When can I apply?
Now, application review and approval can take up to 3 weeks. Apply at: https://covid19relief.sba.gov/ No costs to apply and no obligation to take the loan, if accepted	April 3, 2020 - Small business and sole proprietors April 10, 2020 - Independent contractors and selfemployed individuals You must apply through and existing SBA lender.
What loan amount will my business be approved for?
Maximum: $2 million Loan amount to be calculated based on actual economic injury. An advance of up to $10,000 can be requested in the form of the Emergency EIDL Grant	Maimum: $10 million Likely calculation: 2.5x the average monthly payroll costs, measured over the 12 months preceding the loan origination date.
What are the terms of the loan?
3.75% interest rate for businesses, 2.75% interest rate for non-profits Up to 30 years Loan repayments begin one year after loan origination date (interest is accrued during deferment)	Guidance as of 3/31 by Treasury Dept. indicates interest rates of 0.5% and term of 2 years Loan repayments begin six months after the loan origination date (interest is accrued during deferment)
What about loan forgiveness?
There is no loan forgiveness	Yes, up to 100% of the loan can be forgiven if funds are used appropriately
What can I use the loan funds for?
May be used to pay fixed debts, payroll, accounts payable, and other bills that could have been paid had the disaster not occurred *Cannot be used to cover same expenses covered by PPP loan if obtained	Payroll costs, group healthcare benefits, insurance premiums, and interest on mortgages or other debt, rent, and utility payments (Exclusions do apply)
Is a personal guarantee or collateral required?
No personal guarantee is required for loans less than $200,000 Loans Over $25,000 require collateral SBA takes real estate as collateral when available SBA will not decline a loan for lack of collateral	No personal guarantee or collateral required

Information included is summarized and does not include all restrictions. Please contact us directly to help determine what is best for your business at this time.

16610 N. Dallas Parkway, Suite 2700, Dallas, Texas 75248 972-629-9164

1635 Rogers Road, Fort Worth, Texas 76107 817-984-8531

Apr 03 2020

BCBSTX Offers Special Enrollment Options

Special Enrollment Period
BCBSTX are offering groups an optional special enrollment period from March 30 to April 30. This would apply to eligible employees and their dependents who previously declined coverage and now want to enroll, or currently enrolled employees who wish to add an eligible spouse or dependent to their existing coverage.

Relaxed Minimum Hours Requirement

BCBSTX has also relaxed the minimum hours worked requirement for employees to stay on health plans.

From now through April 30, employers can maintain employees who were enrolled on their plans as of March 20, regardless of the eligibility definition stated in their plan or the BPA.
This includes reduced work hours, furlough, leave of absence or layoffs.
Groups do not need to do anything. No paperwork or email is needed, as we will accept current and accurate eligibility files.

This flexibility does NOT apply to those who are newly electing coverage via the special enrollment period (see below).

Apr 03 2020

CARES Act – Paycheck Protection Program – Interim Final Rule Published April 2, 2020

Paycheck Protection Program – Interim final rule published April 2, 2020

In an effort to release timely information, we would like to point out a few highlights from the Interim Final Rule published by the US Department of the Treasury Thursday evening.

Clarification on proof of eligibility for sole proprietors and independent contractors
1. The required support to establish eligibility of sole proprietors and independent contracts list additional options/examples of acceptable support:
  1. Payroll processing records, payroll tax filings, Form 1099-Misc, income and expenses from sole proprietor ship, and
  2. If no such documentation is available, other supporting documentation such as bank records, sufficient to demonstrate the qualifying payroll amount.
This publication specifically excludes nannies and housekeepers from eligibility.
The calculation for the monthly payroll cost to calculate how much an entity can borrow has been simplified and includes examples.
Excludes 1099 contractors from the PPP loan calculations as they have the ability to apply on their own.
Interest rate will be 1% – Loan term remains at 2 years.
Limitation on forgiveness – The document specifically states that not more than 25 percent of the loan forgiveness amount may be attributable to non-payroll costs.
There have been some clarifications on the documentation required for the loan – work with your lender to confirm exactly what is expected.
This publication provides additional information on refinancing your EIDL into a PPP.
1. If your EIDL loan was used for payroll costs, your PPP loan must be used to refinance your EIDL loan.
2. If your EIDL Loan was not used for payroll costs, the amount refinanced into the PPP must consider that 75% of the PPP loan proceeds must be used for payroll costs.
3. Proceeds from any advance up to $10,000 on the EIDL loan will be deducted from the loan forgiveness amount on the PPP loan.

Please note that these are a few areas that we believe are substantial changes from initial interpretations of the CARES Act or are most relevant for our clients and friends. We encourage everyone to review the full publication from the Department of the Treasury here.