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Critical HIPAA Compliance Gaps Exposed by HHS

Over the last couple of years, the Department of Health and Human Services (HHS) conducted "desk audits" of 166 covered entities and 41 business associates. These audits focused on select HIPAA privacy, security and breach notification requirements. HHS has not released its official findings from the audits yet, but it has identified serious compliance gaps in the following areas: Security risk analysis Security risk management Right of access to protected health information (PHI) Employers that sponsor group health plans should periodically review their compliance with HIPAA rules, including whether their security analysis and risk management for electronic PHI is up to date. Employers should also...

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2018 ACA Reporting Draft Forms Now Available

The IRS released draft 2018 forms for Affordable Care Act (ACA) reporting under Internal Revenue Code (Code) Sections 6055 and 6056. Draft instructions for 2018 have not yet been released. The 2018 draft forms are substantially similar to the final 2017 versions. However, the revised version of the Form 1095-C clarifies that the “Plan Start Month” box in Part II will remain optional for 2018. The IRS previously indicated that this box may have been mandatory for the 2018 Form 1095-C. Keep in mind that the 2018 draft instructions for these forms may include additional changes or clarifications, once released. Also, the...

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New Rule Eases Formation of Association Health Plans

Rule Permits Associations Based on Industry or Geography The U.S. Department of Labor (DOL) has issued a new rule that allows employers to join together as a single group to offer group health insurance coverage to employees, working owners (including those without other employees), and their spouses and dependents as part of an "association health plan." The rule allows association health plans to be formed on the basis of industry or geography, such as by state, city, county, or multi-state metropolitan area. The new rule subjects association health plans to the nondiscrimination rules currently applicable to large group coverage under the Health...

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Overview of Employer Responsibilities for Handling MLR Rebates

The Affordable Care Act's medical loss ratio (MLR) rules require group health insurance issuers to provide rebates if their MLR—the amount of health insurance premiums spent on health care and activities to improve health care quality—falls short of the applicable standard during a reporting year. Each year's rebates must be issued to plan sponsors by September 30 of the following year. As a result, plan sponsors should be looking for these rebates to arrive in the coming weeks. Employer Distribution The MLR rules provide that issuers must pay any rebates owed to persons covered under a group health plan to the policyholder,...

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SIMA presents Justin’s Drive for Independence

As so many of you know, our good friend and colleague, Justin Bennett, suffered a traumatic spinal cord injury in July 2016 that rendered him a quadriplegic at the age of 26. You can read Justin’s story here. Two years, multiple surgeries, countless hours of therapy, and a relentless number of prayers later, Justin is in the planning stages of coming back to work at SIMA, returning to the clients and colleagues to whom he has such close ties. Justin continues to show remarkable determination, perseverance and strength and manages to impress each of us on a daily basis; we are...

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SIMA Welcomes Ashley Vice, CFA, CFP®

We are excited to announce that Ashley Vice, CFA, CFP® joined our wealth management team as a Portfolio Manager earlier this summer. Ashley works with clients to identify their investment objectives and goals and to implement their portfolio investment strategy in accordance with the firm’s overall investment approach.  Working closely with the SIMA team, Ashley supports clients in assessing their comprehensive financial condition, including tax, trust and estate planning. Ashley began his career as a financial advisor at Merrill Lynch and was most recently a Client Advisor at Mercer Advisors – one of the largest independent fee-only advisory firms in the country. ...

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Virginia Tax Credits

Making the most of available tax credits is a key component in any plan for minimizing tax liabilities.  Remember, tax credits are much more valuable than deductions because they reduce the amount of tax owed on a dollar-for-dollar basis.  Did you know that Virginia has numerous tax credits in place to help their residents and business owners save money?  Unfortunately, these tax credits are often overlooked and many taxpayers are not taking full advantage of the potential tax savings.  Below are just a few of the Virginia tax credits available that will help you to be better prepared for next...

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Do your employees need a paycheck check-up?

IR-2018-145, June 28, 2018 Taxpayers who owed additional tax when they filed their 2017 federal tax return earlier this year can avoid another unexpected tax bill next year by doing a “paycheck checkup” as soon as possible, according to the Internal Revenue Service. The Tax Cuts and Jobs Act, the tax reform legislation passed in December, made major changes to the tax law, including increasing the standard deduction, removing personal exemptions, increasing the Child Tax Credit, limiting or discontinuing certain deductions and changing tax rates and brackets. These far-reaching changes could have a big impact on the tax refund or balance due on...

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Involuntary Termination

Each step in the process of terminating an employee should be carefully executed.  Each step must be carefully and thoroughly documented.  If an employee is discharged for poor performance and later sues alleging discrimination, the employer will have a difficult time defending if the personnel file is devoid of any documentation of the poor performance over a reasonable period of time. Terminating an employee is a very sensitive matter, requiring careful communication and documentation to avoid potential lawsuits or other future problems. It is prudent to consult an employment law attorney or HR specialist before taking any specific steps should the...

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Summary Annual Reports Due Sept. 30

Health plans with 100 or more plan participants at the beginning of a plan year are generally required to furnish a Summary Annual Report (SAR) to each health plan participant within 9 months after the end of a plan year. As a result, the deadline for most calendar year plans to satisfy the SAR requirement for plan year 2017 is September 30, 2018. What Must be in a SAR? A SAR serves as a narrative summary of the group health plan's Form 5500 annual report. In general, a SAR must provide the following information on the plan year (among other things): Name of...

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