Aca Affordability Updates, Chip Notice, Rebates, Overdose Awareness Week, Colorado Paid Leave & Illinois Vessa Amendments

Navigating through the labyrinth of US employee benefits regulations, August 2023 emerged as a milestone month with several noteworthy updates. The Internal Revenue Service (IRS) recalibrated the Affordable Care Act (ACA) affordability percentage to 8.39% for plan years commencing in 2024, influencing employers with a workforce of 50 or more. The Department of Labor unveiled an updated model Employer Children's Health Insurance Program (CHIP) Notice, applicable to employers with group health plans in states facilitating premium assistance subsidies. Colorado amplified employee rights to paid leave under the Colorado Healthy Families and Workplace Act, now encompassing bereavement and management of financial and legal matters post death. Illinois revised the Victims Economic Security and Safety Act (VESSA), incorporating new grounds for leave linked to deaths from violent crimes.


Additionally, President Biden ushered in Overdose Awareness Week, focusing on the national drug overdose crisis.


IRS Affordability Percentage Change

In a significant shift, the Internal Revenue Service (IRS) has reduced the Affordable Care Act (ACA) affordability percentage to 8.39% for plan years commencing in 2024. This effectively tightens the belt on employers with 50 or more employees by mandating them to offer health plans that do not surpass this percentage of an employee's household income for self-only coverage.


The move underscores the importance of the ACA affordability requirements, which are designed to ensure accessible health care for all. To assist in determining affordability, the IRS provides three safe harbors: Federal Poverty Level, Rate of Pay, or W-2 Wages.



Non-compliance with these guidelines may incur penalties, underscoring the necessity for employers to adapt to this change in a timely and informed manner.


Determining ACA Affordability

For the 2024 plan year, the IRS has adjusted the percentage threshold for health plans offered by large employers to be considered affordable, to 8.39% of an employee's household income for self-only coverage. To determine ACA affordability, employers have three safe harbors: Federal Poverty Level, Rate of Pay, or W-2 Wages.

  • Federal Poverty Level: This option bases the calculation on the federal poverty line for a single individual.
  • Provides certainty and simplicity in calculations.
  • Can lead to lower costs for employers.
  • Rate of Pay: The affordability calculation is based on the lowest hourly wage of an employee.
  • Allows for adjustments based on individual employee wages.
  • W-2 Wages: The calculation is based on the employee's annual W-2 earnings.
  • Accommodates for fluctuations in income throughout the year.

Compliance with ACA affordability is essential as non-compliance may lead to penalties for applicable large employers.

Updated Employer CHIP Notice

Shifting gears to the realm of employer obligations, the Department of Labor has unfurled a revised model of guidelines pertaining to employers with group health plans in states offering premium assistance subsidies, serving as a beacon for businesses in navigating their responsibilities.


These updated Employer CHIP Notices encapsulate the compliance requirements demanded of employers in states that provide these subsidies, offering critical guidance in meeting regulatory standards.


Employers are entrusted with the task of delivering these notices in a flexible manner, though they must ensure that minimum state-specific contact information is included.



This policy underscores the vital role of employer communication in ensuring adherence to statutory mandates. It further illustrates the strategic alignment between federal regulations and the interests of employees, calling for diligent and accurate compliance from employers.


Medical Loss Ratio Rebates

Employers who operate fully insured group health plans may experience the receipt of medical loss ratio rebates from their insurance providers. These rebates, which are to be distributed annually, can be utilized by employers or allocated to plan participants.


The process of calculating rebates accurately can be challenging due to the requirement of determining the plan asset portion. It is critical to ensure that this calculation is accurate to avoid compliance issues.



Moreover, using rebates effectively is essential. Employers have the option of either improving plan benefits or returning the appropriate amount to participants. ERISA regulations necessitate the timely distribution of employee portions of the rebate, although a specific notice about the rebate to employees is not mandatory.


Overdose Awareness Week Proclamation

In an important step towards addressing the national crisis of drug overdoses, President Biden has issued a proclamation establishing a dedicated period of heightened attention and intervention. This initiative, known as Overdose Awareness Week, aims to galvanize comprehensive overdose crisis response at multiple levels.


The administration has implemented a National Drug Control Strategy to streamline efforts in this direction. The strategy is designed to make it easier for healthcare providers to prescribe effective treatments for drug dependency, thus addressing one of the major barriers to treatment.



This initiative reflects a holistic approach to tackling the overdose crisis, acknowledging the need not only for immediate medical intervention but also for long-term strategies focused on prevention, education, and access to quality treatment.


Colorado's Expanded Paid Time Off

The Healthy Families and Workplace Act in the state has undergone modifications to broaden the rights of workers to avail paid time off. Effective August 7, 2023, Colorado has expanded the permissible reasons for taking paid leave to include bereavement and the handling of financial and legal matters post a death.



Additionally, Colorado paid time off can now be used when an employee must evacuate their residence or care for a family member due to inclement weather or unexpected events. Employers are obligated to revise their policies to incorporate these new reasons for paid leave and duly inform employees about their rights. Failure to do so could potentially lead to penalties such as fines or liability for unpaid wages.


VESSA Amendments in Illinois

Modifications to a significant law in the Prairie State now provide additional unpaid time off to employees impacted by violent crime, including those who are victims of domestic, sexual, or gender violence, or affected by crimes of violence in their household. For instance, an employee who has recently lost a loved one due to a violent crime can now take time off to attend the funeral, make necessary arrangements, or simply grieve.

What Employee Benefits Do Georgia Workers Want in 2025?

by Drew Holley • 17 January 2025
Key Insights on Employee Benefits for Small Businesses in Georgia Employee benefits play a pivotal role in attracting and retaining talent, particularly for small businesses striving to compete with larger corporations. BIS Benefits has partnered with Mployer Advisor to bring you an exclusive 2025 Employee Benefits Benchmarking Report, tailored specifically for businesses in the South Atlantic region with 25–49 employees. This blog highlights key findings from the report and how they can help you craft a competitive benefits strategy. Want to dive deeper? Download the full 2025 Employee Benefits Benchmarking Report to gain actionable insights and trends tailored for businesses like yours. Key Findings from the 2025 Employee Benefits Benchmarking Report 1. Medical Benefits: Affordability and Trends 76% of employers in the South Atlantic region offer medical benefits, with 63% of employees enrolling. On average, small businesses contribute $580 per month for single coverage and $707 for family coverage —in line with regional benchmarks. High-deductible health plans (HDHPs) with health savings accounts (HSAs) are gaining traction as cost-saving options. What this means for your business: Offering at least one affordable plan option with employer contributions around regional averages helps you stay competitive in the labor market. 2. Supplemental Benefits: A Strategic Edge Dental and vision benefits are offered by over 80% of employers in this cohort, with high employee enrollment rates of 98% and 93%, respectively. Life insurance payouts are commonly structured as multiples of earnings, with the majority of plans offering 1–2x salary coverage. Voluntary benefits such as critical illness and accident insurance are being increasingly adopted to attract talent without significant cost increases. Takeaway: Supplemental benefits can enhance your overall offering without breaking your budget. Highlight these options to potential hires to differentiate your package. 3. Retirement and Financial Benefits: Securing the Future 91% of employers offer defined contribution retirement plans (e.g., 401(k)), with 74% of employees participating. Employer matching contributions average between 4%–6% , a vital component in employee retention. Auto-enrollment and auto-escalation features are becoming standard, simplifying the process for employees and increasing participation. Action Step: Ensure your retirement plan includes competitive matching and user-friendly features like auto-enrollment to boost engagement. 4. Leave and Flexibility: Meeting Modern Expectations Consolidated leave programs (combining sick, vacation, and personal days) are offered by 69% of employers , reflecting a trend toward greater flexibility. Remote work options and flexible schedules are growing in popularity, with 40% of businesses offering work-from-home arrangements . How to stand out: Consider adding or expanding remote work policies and flexible scheduling to meet employee expectations in 2025. Why Download the 2025 Employee Benefits Benchmarking Report? This comprehensive report provides: Regional and national comparisons to help you understand how your benefits stack up. Detailed insights into cost-sharing, plan designs, and employee preferences. Actionable data on emerging trends like HDHPs, flexible leave policies, and wellness programs. The report equips Georgia small businesses with the knowledge needed to craft a competitive benefits package that aligns with employee needs and business goals. Download the Report Today Don’t miss out on the opportunity to gain insights that can transform your benefits strategy in 2025. Download the full report here by entering your email address and receive actionable data to help your business attract and retain top talent.

HDHPs: How High Deductible Health Plans Can Save Money for Employers and Employees

by Drew Holley • 6 January 2025
High Deductible Health Plans (HDHPs) are transforming how employers and employees manage healthcare costs. By offering lower premiums and pairing seamlessly with Health Savings Accounts (HSAs) , HDHPs provide a strategic way to save money while maintaining access to quality healthcare. In this article, we’ll explore how HDHPs work, their benefits for employers and employees, and how to maximize their potential. To learn more about the benefits of HDHPs and related options, visit our Group Benefits page . What Are HDHPs? HDHPs are health insurance plans characterized by higher deductibles and lower monthly premiums. These plans encourage smarter healthcare spending, as individuals must pay for medical expenses out-of-pocket until their deductible is met. A significant advantage of HDHPs is their compatibility with HSAs. HSAs allow employees to save pre-tax dollars for qualified medical expenses, reducing taxable income and providing a long-term financial safety net. Unlike Flexible Spending Accounts (FSAs), HSA funds roll over year after year, making them an ideal savings tool. To better understand the differences between HSAs and FSAs, check out our detailed guides on Health Savings Accounts and Flexible Spending Accounts . The Employer Advantage: Cost Savings and Competitive Benefits Employers benefit significantly from HDHPs because they reduce overall premium costs while providing employees with greater flexibility. These plans can be part of a larger strategy to attract and retain top talent, especially when paired with proper education about HSAs. Offering HDHPs demonstrates a commitment to cost-effective, forward-thinking benefits management. Businesses can tailor these plans to align with workforce needs, ensuring employees feel supported while keeping costs under control. For help designing a comprehensive benefits package, visit our Group Benefits page for insights on tailoring solutions for your team. The Employee Advantage: Affordable and Flexible Coverage For employees, the main draw of HDHPs is their affordability. With lower premiums, employees can save on monthly healthcare costs while taking advantage of HSAs to manage out-of-pocket expenses. HSAs offer employees tax savings, flexibility, and long-term benefits, making them an excellent choice for those planning for future healthcare needs. This is especially valuable for individuals and families who don’t anticipate frequent medical expenses but want to ensure coverage for unexpected costs. Learn how to maximize your savings with our guide to Health Savings Accounts , a vital companion to any HDHP. Key Differences: HSAs vs. FSAs While both HSAs and FSAs offer tax advantages, they differ significantly in how funds are managed. HSAs allow for funds to roll over indefinitely and are owned by the employee, even if they change jobs. FSAs, on the other hand, are subject to the "use it or lose it" rule, meaning unspent funds may be forfeited at the end of the year. Employees using FSAs should familiarize themselves with rollover and grace period options to avoid losing money. To better understand how these accounts compare, check out our Flexible Spending Accounts overview . Industry Trends: HDHPs Are Gaining Momentum HDHPs are increasingly popular across various industries, from technology to manufacturing. Businesses see these plans as a way to manage rising healthcare costs while still offering competitive benefits. As employers look for cost-effective solutions, HDHPs stand out as a forward-thinking option that balances affordability with quality. Pairing HDHPs with educational resources ensures employees feel confident in navigating their healthcare choices. Key Takeaways For Employers: HDHPs lower premium costs while providing flexibility for employees. For Employees: When paired with HSAs, HDHPs offer significant tax advantages and long-term savings opportunities. For Everyone: Understanding the differences between HSAs and FSAs is essential for making informed benefits decisions. Whether you’re an employer or employee, HDHPs can be a game-changer for managing healthcare costs. To explore how these plans fit into your benefits strategy, visit our pages on Group Benefits , Health Savings Accounts , and Flexible Spending Accounts . 
Drew Holley and Jessie Couch Discussing HSA and FSA

FSA vs HSA | Which One is Best for your Georgia Employees?

by Drew Holley • 12 December 2024
Use It or Lose It? Demystifying FSAs and HSAs Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are popular options for managing healthcare expenses while enjoying some tax benefits. However, these two accounts differ significantly in how unused funds are handled at the end of the year. This difference can impact your financial planning and overall healthcare strategy. In this article, we'll delve into the "use it or lose it" concept, explore how it applies to FSAs, and compare it with HSAs, highlighting why it's important to understand these rules when making your benefits choices. For more information on HSAs and FSAs, watch the full episode of the BIS Podcast here or below. FSAs and the "Use It or Lose It" Rule FSAs have traditionally been governed by a "use it or lose it" rule. This means that any unspent funds in your account at the end of the year would be forfeited. This requirement made it crucial for employees to accurately estimate their healthcare costs and spend all allocated FSA funds before the year ended. However, since the introduction of the Affordable Care Act (ACA), things have changed. Today, many employers offer more flexibility with FSAs. Thanks to the ACA, employers may now allow employees to carry over a limited amount of unspent funds from one year to the next—originally $500, now adjusted for inflation to about $650. Alternatively, some employers may offer a grace period of up to two and a half months after the end of the plan year to use any remaining funds. It’s important to know what rules apply to your FSA so that you don’t leave any money on the table. To learn more about maximizing your benefits options, check out our guide on employee benefits strategy . HSAs: A Different Story Unlike FSAs, HSAs do not follow the "use it or lose it" rule. Funds contributed to an HSA remain in the account year after year, regardless of whether or not you use them. This is one of the key benefits of an HSA—you can build up savings over time to cover future medical expenses. Plus, the funds in an HSA are portable, meaning you take them with you if you change jobs or retire. This makes HSAs a valuable tool for long-term healthcare planning. If you're considering switching to a High Deductible Health Plan (HDHP) to become eligible for an HSA, it’s important to weigh the pros and cons. For more information about HDHPs and their compatibility with HSAs, check out our Health Savings Account service page . Making the Most of FSAs and HSAs Whether you choose an FSA or an HSA, it’s important to understand how to make the most of these accounts. For FSAs, knowing your employer's specific rules about rollover and grace periods can help you avoid losing funds. For HSAs, the focus should be on maximizing contributions, as the funds will continue to grow tax-free, providing a cushion for future medical needs. Both FSAs and HSAs can be used for a wide range of eligible expenses, including medical, dental, and vision care. If you want a comprehensive overview of your coverage options, our group health insurance page is a great resource. Additionally, if you work in a specialized industry like construction or technology, it's beneficial to explore options that are tailored to your needs. Industries like construction and technology have unique challenges that may impact the type of coverage you choose, including how you use tax-advantaged accounts like FSAs and HSAs. Key Takeaways About FSAs, HSAs, and the "Use It Or Lose It" Rule: FSAs : Historically governed by a "use it or lose it" rule, thanks to the ACA, employers may now allow employees to carry over a limited amount of unspent funds from one year to the next—originally $500, now adjusted for inflation to about $650. Be sure to understand your employer's policies. HSAs : Funds roll over year after year and are portable. HSAs offer significant long-term savings opportunities, particularly for those on HDHPs. Plan Carefully : Knowing how these accounts work can save you money and help you better prepare for healthcare costs now and in the future. To get more insights into how you can make the most of your employee benefits, visit our resources page and discover helpful tools to make informed decisions for yourself and your family.
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