Despite employers’ best efforts to offer competitive health care benefits to workers, many employees struggle with medical debt. According to a new survey commissioned by Goodroot, a community of health care companies, more than 4 in 10 employees report having experienced medical debt. “When employees are struggling with a massive, unpayable medical bill, it not only puts tremendous stress on their family but also harms their ability to be productive and contribute to company culture.” - Goodroot CEO Mike Waterbury Medical Debt in the United States In 2023, employers spent an average of $17,393 for family coverage per employee, a 48% increase since 2013. Although employers increasingly invest in their sponsored health care benefits, employees still face medical debt. Consider these key findings from the Goodroot survey: Medical debt remains the leading cause of bankruptcy in the country. Half (52%) of Americans in medical debt owe more than $2,500. Medical debt impacts employees’ ability to cover daily living expenses. At some point, nearly 4 in 10 people have been unable to afford rent, groceries or utilities due to medical bills. People are delaying health care in anticipation of high costs. The majority of Americans (86%) who have experienced medical debt delayed care due to the expected cost. Younger workers are more likely than older ones to experience medical debt, and their debts are larger. Of employees aged 42 or under with medical debt, 59% owe more than $2,500, compared to 45% of workers aged 43 or older. Goodroot stressed that employees often are unaware that financial help is available. Hospitals are federally mandated to offer “community benefits, including free or discounted urgent and medically necessary care to patients unable to pay.” However, each health system has its own financial assistance policy, eligibility criteria and application form, which can be confusing for patients. Employer Takeaway Medical debt is taking a toll on many Americans. Employers can help their workers by integrating hospital financial assistance into health benefits. In addition to health care benefits, some employers are also exploring providing a health-cost navigator who will work directly with employees to help them understand and use their benefits effectively by comparing pricing, reviewing bills and negotiating costs. Employers should continue to monitor health care and benefits trends. Contact us for more resources.
Keeping up with compliance developments can be difficult and time-consuming. This quarterly update highlights recent legal developments to help your organization stay on top of new requirements and minimize its compliance risks. Recent Federal Developments DOL Issues Independent Contractor Final Rule On Jan. 10, 2024, the U.S. Department of Labor (DOL) issued a final rule, effective March 11, 2024, revising its guidance on how to analyze who is an employee or independent contractor under the Fair Labor Standards Act (FLSA). The DOL’s new rule reinstates the multifactor and totality-of-the-circumstances analysis, which is generally viewed as more employee-friendly. As a result, the new rule will likely lead to more workers being classified as employees. DOL Updates Model Employer CHIP Notice The DOL has released a new model employer Children’s Health Insurance Program (CHIP) notice with information current as of Jan. 31, 2024. An employer is subject to this annual notice requirement if its group health plan covers participants who reside in a state that provides a premium assistance subsidy under a Medicaid plan or a CHIP, regardless of the employer’s location. The DOL’s model notice, which employers may use for this disclosure, is updated periodically to reflect changes in the states that offer premium assistance subsidies. Employers Must Use New Form I-9 As of Nov. 1, 2023, employers are required to use the newest version of the Employment Eligibility Verification form (Form I-9). The new Form I-9 includes updated instructions and many notable changes, including alternative remote verification procedures that employers enrolled in E-Verify can use to comply with their Form I-9 obligations. Employers should ensure they are using the new Form I-9, as continuing to use the outdated Form I-9 can trigger penalties. NLRB Issues New Joint Employer Final Rule On Oct. 27, 2023, the National Labor Relations Board released a final rule establishing new, broader criteria for determining joint-employer status. Joint employment situations can happen when two or more employers share personnel hiring, supervision and management practices. When a joint employment status exists, joint employers are equally responsible for compliance with applicable laws and regulations. The final rule had been set to take effect on Feb. 26, 2024. However, on Feb. 22, 2024, a federal judge in the U.S. District Court for the Eastern District of Texas delayed the implementation of the final rule to Mar. 11, 2024. DOL Increases Civil Penalty Amounts for 2024 On Jan. 11, 2024, the DOL released its 2024 inflation-adjusted civil monetary penalties that may be assessed on employers for violations of a wide range of federal laws, including the FLSA, ERISA, the Family and Medical Leave Act, and the Occupational Health and Safety Act. For example, the maximum penalty for failing to file a Form 5500 for an employee benefit plan increased from $2,586 to $2,670 per day. Employers should periodically review their pay practices, benefit plan administration and safety protocols to ensure compliance with federal requirements. EEOC Increases Enforcement Activity The U.S. Equal Employment Opportunity Commission (EEOC) is a federal agency responsible for enforcing federal employment discrimination laws, such as Title VII of the Civil Rights Act, the Americans with Disabilities Act and the Pregnant Workers Fairness Act. The EEOC experienced several noteworthy changes in 2023, including new leadership, structural changes and an increased budget. It also multiplied its enforcement efforts; at the end of fiscal year 2023, the agency reported a 52% increase in lawsuit filings from the previous year. These efforts are likely to continue in 2024. Recent State Developments New York Increases Salary Threshold for Exempt Employees On Sept. 15, 2023, New York State amended its Labor Code to increase the salary threshold executive, administrative and professional (EAP) employees must meet in order to qualify for the state’s exemptions from pay frequency laws. Beginning March 13, 2024, EAP employees who earn less than $1,300 per week (up from $900 per week) will be subject to the same wage payment protections as other nonexempt employees. For more information on these topics, please contact Simco.