Why It’s Important to Know Your Limits for 2023 Benefit Plans

Why It’s Important to Know Your Limits for 2023 Benefit Plans

At various times of the year, the IRS announces benefit plan limits for the following year. It’s important to understand these limits – and make sure your benefit-eligible employees do, too – in order to maximize what your company and employees get out of the benefit plans you invest in and offer.

Benefit plans are a great way to enhance your company’s employee value proposition and support your attraction, recruitment, and retention efforts. To maximize the investment you and your employees make in benefit plans, it’s important to provide clear and frequent communication explaining how benefits work and what employees can do to get the most from them. This is especially true when a communication can help an employee gain tax advantages and avoid losing money – this is where plan limits come in.

For example, earlier this year the IRS announced 2023 health care flexible spending account (FSA) limits are increasing to $3,050 (from $2,850 this year). That’s good news, as it helps employees put aside more tax-free money to pay for eligible out-of-pocket health care expenses, while reducing their taxable income – both of which will no doubt be welcomed given inflation and the current economic environment.

There are three caveats:

  1. Employees need to know about changes to limits and what it could mean to them.
  2. Employees need to know how to change their benefit elections to take advantage of new limits.
  3. Employees need to know what happens if they don’t use health care FSA funds and file claims by IRS deadlines (they lose the money). Extended grace periods for using the money in 2020 and 2021 due to federal stimulus packages are not available in 2023.

The important phrase here is “employees need to know.” If you also offer a high deductible health plan with a health savings account (HSA), things get even more complicated. Employees need to know whether an FSA or HSA is best for their situation.

See how complicated it can get? That doesn’t even get into defined benefit, defined contribution, compensation, and other IRS limits that will apply in 2023.

Since you have a business to run and may or may not have the resources who can spend the time educating your employees about all of the ins and outs of benefits, you may want to reach out to your benefits administrator for help.

RBT CPA’s affiliate — Spectrum Pension and Compensation – offers third party administration and related services (including communication) for clients in the Hudson Valley and beyond. While you won’t be competing with Fortune 100 companies for attention, you will get customized, personalized services to ensure compliance while promoting the value your plans deliver to your company and team.

Interested in learning more? Click here to see the summary of 2023 limits Spectrum shared with its clients and prospects just a few weeks ago and here to learn what Spectrum can do for your business and employees in 2023 and beyond.

How Biden’s Student Loan Relief Impacts Employer Plans and Planning

How Biden’s Student Loan Relief Impacts Employer Plans and Planning

Some employers had found a competitive edge in recruiting and retention by offering student loan assistance benefits. Others were considering adding them to their rewards programs. Then, Biden’s student loan relief was passed, leaving employers to ponder their next move.

As reported on BenefitsPro.com in September, 4 of 10 employers are taking another look at what to do with student loan benefits following the release of Biden’s plans. “The administration is directing the U.S. Department of Education to cancel $10,000 in federal student loan debt for borrowers earning less than $125,000 annually. Pell Grant recipients will see up to $20,000 eliminated. According to the White House, this initiative will assist up to 43 million borrowers, including eliminating the full remaining balance for roughly 20 million people.”

In an International Foundation of Employee Benefits Plans survey, almost 9% of participating employers offer a company student loan benefit and 16% are considering offering one. 11% are going to take another look at their strategy; 60% don’t plan on making any changes; and 31% don’t know what they’re going to do. Of the employers that do offer a benefit, 28% reimburse the employee directly; 21% offer refinancing; and 3% provide a match in a defined contribution account. Participating employers indicate student loan benefits help with retention and recruitment; reduces employees’ financial stress; and drives employee engagement. On the other hand, some employers have faced pushback from employees who don’t benefit.

What do employees think? As reported on BenefitNews.com, a survey conducted by Betterment at Work found almost 60% of employees felt their employer should help them pay off debt. 74% indicated they’d leave their jobs for another company offering loan repayment benefits.  Perhaps the most potent finding: 86% would stay with an employer for at least five years if they offered repayment benefits.

Employers striving to regain their footing following the Great Resignation and Great Reshuffling may want to take note, especially since the impact of Biden’s plan is limited to those who incur Federal student loan debt by June 30, 2022 and who meet certain income requirements. Even after Biden’s plan pays out benefits, 23 million will still have student loan debt (not including new debt incurred after June 30.)

According to Forbes, more than 50% of today’s students leave college with debt, the average being $28,950. 92% of loans are federal, with the balance being private. Borrowers between 25 and 34 owe about $500 billion in federal student loans; between 35 and 49 owe $620 billion; between 50 and 61 owe about $282 billion; and 2.4 million aged 62 or older owe $98 billion in student loans.

The application for student loan forgiveness under the Biden plan is scheduled to open this month. Eight million people are expected to receive automatic forgiveness; the balance need to apply, but there are some issues being worked through. Just last week, eligibility was scaled back due to legal challenges. In addition, some borrowers want to opt out of the loan forgiveness to avoid state taxes that they would not be subject to otherwise. The number of cases on the docket challenging the law is rising.

While details surrounding Biden’s plan are being settled, the clock is ticking on another benefit offered under the Coronavirus Aid, Relief and Economic Security (CARES) Act to employers. As reported by The College Investor,  “Section 2206 of the CARES Act allows a portion of employer provided student loan assistance to be excluded from income. Whether those payments are made directly to the employee or the lender, they will be tax-free. The income exclusion is up to $5,250 per year per employee.” As of now, this tax advantage is available through December 31, 2025.

For updates on Federal Student Loan Forgiveness, sign up on the U.S. Department of Education subscription webpage.

While we’re not benefit experts or lawyers, at RBT CPAs, we do know taxes, audits and accounting. If you have any questions about how the CARES Act income inclusion may impact your company, give us a call. We’ve been supporting businesses and municipalities in and around the Hudson Valley for over 50 years.

Inflation Reduction Act Healthcare Provisions’ Rollout Timeline

Inflation Reduction Act Healthcare Provisions’ Rollout Timeline

When the Inflation Reduction Act (IRA) was signed into law in August, there was a huge rush to figure out what the law meant and what it would do. Now that we’ve had a little time to reflect on it, one striking characteristic is that the health care provisions roll out over a decade, with the majority taking effect over the next four years.

Since we’re accountants – not lawyers, we consulted a multitude of sources to compile the following effective dates for many (but not all) IRA health care provisions – you’ll find a list of those sources at the end of this article. With that, here’s the timeline we came up with…

December 31, 2022

A plan continues to qualify as high deductible even if it does not apply a deductible to insulin-related products.

2023

ACA premium tax credits enhanced in 2021 under the American Rescue Plan Act and due to expire at the end of 2022 and are extended through 2025.

Adult vaccines recommended by the Advisory Committee on Immunization Practices are covered 100% under Medicare Part D with no cost share. (Certain vaccines will be covered 100% under state Medicaid and Children’s Health Insurance Programs as well.)

Annual price increases for certain Part B and Part D drugs are capped at the rate of inflation; otherwise, manufacturers must pay rebates to the Center for Medicare and Medicaid Services (CMS) or face penalties. Rebates for Part B drugs must be paid quarterly (within 30 days of notice). Rebates for Part D drugs must be paid annually (within 30 days of notice). If rebates aren’t paid, penalties equal to at least 125% of the rebate amount apply.

Insulin out-of-pocket costs are capped at $35 per month for Medicare beneficiaries through 2025.

2024

For Medicare Part D, once costs reach the catastrophic phase (above $7,000), the 5% cost-share no longer applies.

Medicare Part D subsidies are available to beneficiaries at or below 150% (up from 135%) of the federal poverty line.

Part D premium is capped at 6% growth annually through 2029.

2025

Medicare beneficiaries’ annual out-of-pocket costs for Part D spending are capped at $2,000.

Medicare Part D sponsors and Medicare Advantage organizations must offer beneficiaries payment plans, subject to a monthly cap, to pay off Part D prescription drug cost-share amounts.

2026

ACA premium tax credits extended under the IRA expire.

Medicare beneficiaries’ insulin costs are capped at the lesser of $35, 25% of the maximum fair price (MFP) for insulin, or 25% of the negotiated price for insulin. Also, coinsurance amounts and adjustments to supplier payments under Medicare Part B for insulin furnished via durable medical equipment are limited.

Under Medicare Part D, the first negotiated prices for 10 drugs with no generic or biosimilar counterpart that account for the greatest Medicare Part D spending take effect. Manufacturers that delay negotiations under the pretense a biosimilar or generic alternative will be available within 2 years but never materializes will be required to pay rebates to HHS. Manufacturers who fail to sell selected drugs at the MFP negotiated will be subject to severe penalties.

2027

Negotiated prices take effect for the 15 drugs on the negotiation list for Medicare Part D.

2028

Negotiated prices take effect for the 15 drugs on the negotiation list for both Medicare Parts B and D.

2029

Negotiated prices take effect for the 20 prescription drugs on the negotiation list for both Medicare Parts B and D.

2030

CMS will recalculate Part D base premiums using the original Part D premium formula.

2032

As reported by the National Law Review, “The IRA extends the moratorium on implementation of the final rule that relates to eliminating the anti-kickback statute Safe Harbor Protection for Prescription Drug Rebates, issued by the Office of the Inspector General on Nov. 30, 2020. The moratorium is extended until Jan. 1, 2032.”

Sources: National Law ReviewPWC, JDSupra.com, Holland & Knight, HealthCareDive.com, BenefitNews, and Kaiser Family Foundation (KFF)


It’s important to note that I am not a lawyer; if you need confirmation of any IRA provisions please consult legal counsel. However, I am an accountant with RBT CPAs – one of the largest firms in the Hudson Valley and beyond. We’re known for our professionalism, ethics, and responsiveness. Should you need any accounting, tax, or auditing assistance, please don’t hesitate to give us a call.

IRS Changed Certain Deadlines for SECURE Act and CARES Act Amendments

IRS Changed Certain Deadlines for SECURE Act and CARES Act Amendments

If you’ve been racing to comply with SECURE and CARES Act retirement plan amendment deadlines, take a breath! In August, the IRS issued Notice 2022-33 extending some deadlines.

As reported by the Society for Human Resource Management (SHRM), private sector 401(k) plan sponsors who took advantage of benefit changes under the Setting Every Community Up for Retirement Enhancement (SECURE) Act and the Coronavirus Aid, Relief and Economic Security (CARES) Act were previously required to make plan amendments this year. The deadline for:

  • Calendar year plans were originally December 31, 2022.
  • Non-calendar year plans were the last day of the first plan year beginning on or after January 1, 2022.
  • Collectively bargained plans were the exception, with the deadline being the last day of the first plan year after the start of 2024.

The IRS notice issued August 3 pushed the deadline back to December 31, 2025, for both calendar year and non-calendar year plans, with a few exceptions: Under the CARES Act, the amendment deadline for loans, in-service withdrawals, and temporary suspension of loan repayments remain unchanged.

It is important to note, there are different deadlines for government plans. Government sponsors of 457 (b) plans and 403(b) plans for public school employees have until 90 days after the close of the third regular session beginning after December 31, 2023, to amend the plan (although the deadline for certain 457(b) amendments resolving compliance issues may be later).

The SECURE Act requires employers to extend eligibility for certain part-time employees starting in 2024; ease withdrawals by new parents for birth or adoption expenses; and permanently increase the start date for minimum distributions from age 70 ½ to 72. However, it’s important to note that further guidance is pending.

The CARES Act, which offered flexibility to employers during COVID, suspended minimum distribution requirements in 2020 and made it easier for new parents to make withdrawals for birth or adoption expenses. Plan loan limits were also doubled to the lesser of $100,000 or 100% of a vested account balance.

Should you need professional assistance with adopting the amendments, making the effective date retroactive, and operating plans as if the amendments are in effect, our Spectrum Pension and Compensation Inc. affiliate can help. For almost 30 years, Spectrum has been assisting employers in the Hudson Valley and beyond with employee benefits, including retirement plans, health insurance, and life insurance. The Spectrum team is available to provide technical assistance in plan design, compliance, administration, and record keeping. Click here for their contact information.

For accounting, auditing, and tax support, RBT CPAs is always here to help. Give us a call.

Reporting for Certain DB & DC Benefit Plans Is Changing

Reporting for Certain DB & DC Benefit Plans Is Changing

If you sponsor a defined benefit plan and/or defined contribution multi-employer plan, take note! There are a few updates to Form 5500 effective for 2022 plan year reporting (Source: Mercer.com; “Latest Form 5500 Updates”).

Form 5500 is used to report about a plan’s qualification, financial condition, investments, and operation. All defined benefit and defined contribution plan sponsors are required to submit a Form 5500 to the IRS and Department of Labor each year.

If you sponsor your own defined benefit plan (referred to as a single-employer defined benefit plan), actuarial information required is changing. First, any plan insured by the Pension Benefit Guaranty Corporation (PBGC) that has at least 1,000 participants must provide 50 years of projected benefits for active, terminated vested and in-pay status – this must be reported in a separate attachment to line 26. Second, plans must report if you elected the 15-year shortfall amortization relief under the American Rescue Plan of 2021.

For multi-employer defined benefit plans, there are changes to Schedule MB and certain existing requirements.

  • Plans that attach reporting withdrawal liability amounts that are part of employer contributions must identify which amounts are periodic and which are lump sum payments.
  • For interest rates, plans must report the rate used for employer withdrawal liability assessment or attach a description of the interest rate assumption.
  • PBGC-covered plans with at least 500 participants will need to project benefits for a 50-year period for active, terminated vested and in-pay participants; they will also have to provide a 10-year projection of employer contributions and withdrawal liability payments.
  • PBGC-covered plans with at least 1,000 active participants must provide average accrued monthly benefits in an age/service scatter.
  • In Retirement Plan Information Schedule R, plans must include the 10 participating employers contributing the highest amounts.

For both single and multi-employer plans, reporting can be in the form of a spreadsheet for 50-year expected benefit payment projects and age/service scatter of active participants. The same applies to withdrawal liability amounts and projected employer contributions and withdrawal liability (Schedule MB only).

When it comes to defined contribution multi-employer plans (MEPs), including pooled employer plans (PEPs), there are a couple of changes to Form 5500 and Form 5500-SF instructions, including new plan characteristic codes to identify the type of DC MEP and clarification about who to name as plan sponsor and administrator.

The changes apply to filings for plan years starting January 1, 2022 or later. 2022 plan year filings are generally due seven months after the end of the plan year. So, the 2022 filing must occur by July 31, 2023 for plans that run on a calendar year. (You can file for a 2 ½ month extension with Form 5558.)

Additional changes are expected in the future. For now, if you have any questions or need assistance gathering information for your Form 5500 or Form 5500-SF, let us know. Click here to get in touch with RBT CPAs.

Note: Form 5500 changes are governed by final rules issued by the Internal Revenue Service, Employee Benefits Security Administration, and the Pension Benefit Guaranty Corporation. If there are any conflicts between the information in this article and the official final rules, the official final rules govern.

Year-End Is Too Late to Get Started on ASC 842 – The Time to Act Is Now

Year-End Is Too Late to Get Started on ASC 842 – The Time to Act Is Now

The new lease accounting standard – ACS 842 – took effect for private and non-profit organizations for fiscal years starting January 1, 2022 (or 2023 for non-calendar year-end entities). While that means at the earliest your organization must account for all leases on your financial statements by the end of this year, there’s a lot of work to be done to meet the new standards. If you haven’t started, now is the time. If you wait until year-end, it will probably be too late.

First, a number of departments/functions may be affected by the change. This includes accounting, tax, real estate, equipment leasing, procurement, treasury, information technology, and legal. Consider creating a task force with representation from all impacted areas to put together a project timeline and plan.

Second, there are several activities you’ll need to complete, from policy development to data management and extraction to technology design, workflow, implementation, and more.  Perhaps one of the biggest considerations is whether you should be adopting a technology solution to automate identifying lease language, monitoring, bookkeeping and more, which is something we strongly recommend.

So, if you haven’t already started, you need to catch up now.  Waiting for year-end is not an option. If you need a refresher or to get reacquainted with ACS 842, following is an overview (originally published by RBT CPAs in August 2021 and updated for healthcare providers). As always, the RBT CPA professionals are available to answer any questions you may have and to support your tax and accounting needs. Give us a call.

Did you know that, in a matter of months, your leases will be accounted for differently due to the new lease accounting standard? While previously only capital leases were recorded on the balance sheet, effective for fiscal years beginning after December 15, 2021, all leases will be on the balance sheet. That translates to January 1, 2022 for calendar year entities, and fiscal 2023 for non-calendar year end entities.

What does this mean moving forward? It means all healthcare organizations – public, private, and non-profit — need to make sure they have a thorough handle on all of their leases that are for longer than 12 months, including those related to real estate and operations. Especially if your organization has grown in recent years by opening new locations outside of its original footprint – which likely required leasing more equipment, the number of leases you may need to review and track could have grown exponentially. Now is the time to review and evaluate contracts.

The new definition of a lease under ASC 842: “a contract, or part of a contract, that conveys the right to control the use of identified property, plant, or equipment (an identified asset) for a period of time in exchange for consideration.” This slight change means that all contracts should be evaluated to determine if they fall within the scope of this new criteria. Contracts that were previously considered leases may no longer meet the lease criteria and vice versa. Be mindful of lease language when you are reviewing your contracts.

There will still be two categories of leases. The leases formerly known as capital will now be called finance leases. The classification criteria remain essentially the same as under the existing standard; the only major difference is the elimination of the bright-line percentages.  All leases that do not meet one of those criteria will be classified as operating.

If a lease contract includes a non-lease element, that non-lease component must be accounted for as a separate contract distinct from the lease itself. For example, the cost of an equipment lease that includes a maintenance contract must be allocated between the two elements and accounted for separately.

Lease liabilities for operating and finance leases will all be accounted for in the liability section the same way capital leases currently are: split between current and long-term. The offset to the liability will be a right of use (ROU) asset. There will be two lines: a ROU asset – operating lease line, and a ROU asset – finance lease line. These ROU assets are all long-term.

The new standard was designed so that there should be minimal impact to your income statement. Operating leases will continue to be recognized as a straight-line expense over the life of the lease. Finance leases will continue to be frontend loaded because the interest is higher at the beginning of the lease than at the end.

The most significant impact will be on the company’s current ratio. Because the ROU assets are all long-term, but the lease liability is split between current and long-term, the current ratio will be negatively impacted. This change will be particularly important for entities with debt covenants that reference the current ratio. If you have significant operating leases that may create an issue with your debt covenants, connect with your bankers now.

Ultimately, it’s important that both the borrower and the lender understand that this is a reporting change, not a change in a company’s financial situation. Having this conversation early on instead of waiting until the last minute will avoid confusion, and a lot of headaches.

DOL Audit Fights Cyberterrorism

DOL Audit Fights Cyberterrorism

Of the many responsibilities Employee Retirement and Income Security Act (ERISA) plan sponsors, fiduciaries, and recordkeepers must uphold, one of the most challenging relates to cybersecurity to protect plan assets and plan participants’ information. The US Department of Labor (DOL) upped the ante associated with cybersecurity last year when it issued first-of-a-kind new guidance in April and, within several weeks, started auditing for compliance.

With cyber threats and attacks on the rise, in April of 2021 the DOL issued a three-part guidance package (Cybersecurity Program Best Practices; Tips For Hiring a Service Provider; and Online Security Tips) and specified plan fiduciaries are obligated to mitigate cybersecurity risks within their own operations, vendors’ operations and prospective vendors’.  To reinforce this guidance, the DOL began requesting information and documents to audit compliance.

According to the Employee Benefits Security Administration, as of 2018, there were an estimated 34 million defined benefit plan participants in private plans and 106 million plan participants in defined contribution plans with estimated American retirement assets exceeding $9 trillion. That’s an attractive target for cyber criminals and threats. The American Society of Pension Professionals and Actuaries indicates that while the April 2022 guidance was the first related to cybersecurity, it complements regulations on electronic records and disclosures to plan participants and beneficiaries about protecting personally identifiable information.

The DOL wasted no time reinforcing cybersecurity is one of its top priories. Within two months of issuing the guidance, it began requesting documents and information about plan cybersecurity policies and practices as part of retirement plan audits.

According to the Society for Human Resource Management (SHRM), the DOL asks for “all documents relating to any cybersecurity or information security programs that apply to the data of the Plan, whether those programs are applied by the sponsor of the Plan or by any service provider of the Plan.” This may include policies, procedures, and guidelines for access controls and identity management; processes for business continuity, disaster recovery and incident response; third-party providers’ management; cybersecurity training; data encryption; documents and communications about past incidents; service providers’ documents and communications regarding cybersecurity capabilities and procedures and how plan data is used, and more.

Bloomberg Tax created a cybersecurity audit checklist for plan fiduciaries based on the DOL guidance, and an action plan to promote compliance. It suggests fiduciaries should get informed about cybersecurity governance; get expert support when needed; identify data flow and storage; and assess fiduciary conduct to date.

Going forward, many sources indicate that while the immediate focus is on retirement plan assets and participants, fiduciaries and plan sponsors may want to prepare to uphold the same guidance for their health and welfare plans.

If you’re unsure about anything related to compliance with the guidance or audits, it’s always a good idea to consult your benefits legal counsel. For assistance with benefit plan accounting, taxes, and audits, you can trust RBT CPAs – a leading provider in the Hudson Valley for over 55 years.

Clamping Down on Anti-Competitive Behavior in Healthcare

Clamping Down on Anti-Competitive Behavior in Healthcare

Last July, President Biden issued Executive Order 14036 to promote competition (and eliminate anti-competitive practices) across a number of industries, including health care, with the hopes of lowering prices, increasing growth and wages, and promoting innovation. The order includes 72 initiatives, including four specifically focused on health care.

In this post, we explore what has happened since the executive order was issued and what’s expected to happen next in relation to the health care initiatives.

Lowering prescription drug costs

Two months after the executive order was issued, the Department of Health and Human Services (HHS) released, “A Comprehensive Plan for Addressing High Drug Prices.” A recent Congressional Budget Office report on prescription drug costs and spending indicate cost increases are slowing but that’s only after seeing spending increase from $30 million in 1980 to $335 million in 2018.

In 2021, 20 states enacted 43 laws to lower costs that included establishing Prescription Drug Affordability Boards (PDABs); regulating Pharmacy Benefit Managers (PBMs); limiting out-of-pocket  insulin costs; and promoting cost transparency. According to the National Conference of State Legislators Bill Tracking Database, New York State introduced 69 bills related to lowering prescription drug costs last year; another 20 have been introduced since the start of this year.

Allow hearing aids to be sold at drug stores

The Food and Drug Administration (FDA) proposed a rule creating a category of hearing aids that could be sold over-the-counter at drug stores without a prescription. The rule was up for public comment during a 90-day period ending January 18 of this year.  According to Harvard Health, approval is expected some time this year and manufacturers are already moving ahead with production that will give consumers access to a $600 on-average device (versus the $5,000 average at a doctor’s office).

Still, 42 states are asking that as part of the rule the FDA preserves related state consumer protection laws. At the same time, the Federal Trade Commission  indicates that, in part, some of those laws hurt competition and access to affordable hearing aids. Several governors are asking that the FDA finalize the rule without delay. 

Stop the negative impacts of healthcare industry consolidation

The Justice Department and Federal Trade Commission (FTC) are encouraged to review merger guidelines to ensure patients are not harmed by hospital mergers, which have traditionally driven up prices and left rural areas without adequate access to care. As a first step, the FTC restored a policy where it could restrict two merging parties from moving forward if it would have anti-competitive impacts on the community. Courts seem to align with this position. However, the American Hospital Association disagrees, asserting current practices actually boost competition and help the economy. Also, a study by the American Medical Association shows mergers actually result in better patient outcomes – something the medical community asserts the political establishment is ignoring.  The FTC is currently soliciting public comments on the issue. So, stay tuned.

Address surprise bills from hospitals

Even before President Biden’s executive order, actions were underway to promote hospital price transparency and eliminate surprise bills for care. This past January 1, new rules took effect under the No Surprises Act requiring uninsured patients receive good faith estimates for the cost of care and insured patients don’t receive surprise bills for emergency care and treatment by an out-of-network provider at an in-network facility.

What’s more, with the Consolidated Appropriations Act of 2021, health plans and health plan issuers are required to track and submit certain prescription drug and health care costs starting December of 2022 (for 2020 and 2021 data) and every June thereafter to help promote price transparency.

Going forward

For decades, addressing escalating health care costs in the U.S. has been the focus of legislation, corporate board rooms, and individuals, and it looks like it’s going to remain a hot topic with both the FTC and the HHS identifying actions related to Executive Order 14036 a priority for 2022.

We’ll keep you updated as the story continues to unfold. In the meantime, RBT CPAs does have staff specializing in accounting and taxes for health care. Should you need advice or assistance, please give us a call.

NOTE: RBT CPAs is an accounting and tax firm – not a law firm. In no way should information in this article be construed as legal advice or direction. For that type of assistance, we encourage you to contact your legal advisor.

Limited-Scope Audits Expand Auditor and Plan Sponsor Responsibilities

Limited-Scope Audits Expand Auditor and Plan Sponsor Responsibilities

Effective December 15, 2021, new standards apply to audits of financial statements for employee benefit plans subject to the Employee Retirement Income Security Act (ERISA). While this primarily expands what’s required of an auditor, plan sponsors have some new responsibilities as well.

Employee retirement and health plans are legally required to undergo an audit – by a qualified accountant – at a plan’s year end to help protect plan participants. The auditor inspects financial accounts and issues a report on the plan. The audit helps hold those managing and controlling a plan accountable in their fiduciary responsibilities. After a United States Department of Labor assessment showed these audits had major deficiencies, new standards were issued.

The new standards apply to “limited-scope audits,” which are now called Statement on Auditing Standards (SAS) No. 136 ERISA Section 103(a)(3)(C) audits. Under the new standards, an employee benefit plan’s annual reporting obligations are expanded. Along with Form 5500, the auditor’s report must include an opinion on financial statements, schedules, and accounting principles and practices.

To start, a plan sponsor must provide a letter confirming eligibility for a Section 103(a)(3)(c) audit and acknowledge responsibility for plan administration (including maintaining the plan document and amendments; ensuring plan transactions are consistent with plan provisions; and maintaining accurate records to determine participants’ plan benefits). The letter must state the audit is permissible; investment information was prepared by a certified bank, insurance carrier or similar institution; and the certified investment information meets the new requirements, and is appropriately measured, presented, and disclosed.

In addition, the plan sponsor must provide a substantially complete draft Form 5500 – with forms and schedules that may affect the audit — to the auditor before he/she can move ahead with the engagement.

In turn, the auditor will evaluate the plan and use a new format to report findings. The report provides more transparency by requiring more details about the auditor’s opinion and basis for that opinion, as well as financial statements and the audit of those statements. The audit must include reportable findings that include noncompliance or suspected noncompliance with applicable laws and regulations; findings relevant to those who oversee financial reporting and governance; and/or an indication of deficiencies in internal controls warranting attention. Any reportable finding must be communicated in writing to those responsible for governance so it can be addressed in a timely manner.

While they require a bit more work, the new standards are a positive for plan participants and sponsors by promoting transparency and compliance, while uncovering potential issues when they are easier to rectify.

To ensure compliance, plan sponsors should start the process earlier than usual, so they can be sure to select a qualified, experienced auditor (like RBT CPAs), and have the time to gather and complete required paperwork and forms.

Your RBT CPAs partner is ready to walk you through the new process and conduct an audit to ensure compliance with the new standards. Give us a call so we can help you get started today.

SOURCES: SHRM, RSMUS, Employee Benefit Plan Audit Quality Center (EBPAQC), Plansponsor.com

Patient Satisfaction & Your Financial Future

Patient Satisfaction & Your Financial Future

Healthcare and the delivery of healthcare services is often a matter of life and death and there has been an increased intensity of those in need of medical help and, as a result, a significant increase in the demanding workload on the healthcare workforce.

Patients deserve quality care and healthcare employees deserve on-the-job satisfaction to provide quality care.  Thoughtful considerations must go into how stressful and challenging the work of a healthcare provider is and how it impacts patients with either a negative or positive outcome as it links to public investment in hospital care. To succeed in 2022, healthcare organizations must address this concerning connection to sustain high-quality healthcare readiness and the funding that makes access possible.

According to News: Medical Life Sciences, 2021 studies show that there is a critical link between hospitals’ healthcare compensation, healthcare workers’ well-being, and patient satisfaction surveys. It is impossible to separate this idea from The Center for Medicare and Medicaid Service (CMS), whose goal is to empower consumers and hold hospitals accountable for improving care by implementing the Medicare payment system that ties patient care experiences with hospital reimbursement rates.  Since 2008, CMS endorses the publishing of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scoring system that provides qualitative data to rate patient experiences using Value Based Performance Standards (VBP). Specifically, all the dimensions surveyed are consumer-driven factors that contribute to well-being and satisfaction, such as the conditions of the hospital environment (noise level, cleanliness), the social climate (interactions, responsiveness), and information access (discharge, care transition). When any of these factors are receiving unsatisfactory or poor scores, it can negatively affect healthcare employees’ job satisfaction due to significant stressors, thereby affecting customer satisfaction–and hospital funding. Let’s face it, there are billions of dollars from Medicare at stake.

Certainly, the stressors of the still raging pandemic in the healthcare field highlight the need to address and prevent undue burdens on our healthcare professionals as we move into 2022. The real burdens of occupational pressures on the healthcare providers on the front lines translate into their ability to provide quality care experiences.  Patient experiences of care across the nation certainly reflect the caregiver’s burden in the HCAHPS VBP scores so healthcare leaders can utilize this data in practical and useful ways. Healthcare organizations have an obligation to fundamentally do good by their healthcare professionals and consequently increase positive outcomes for patients.

What steps can you take to boost patient satisfaction and secure healthcare funding?

  • Ensure adequate funding and allocate funding resourcefully
  • Elicit feedback from healthcare professionals to allow for emerging new ideas
  • Provide empowerment opportunities to those who feel a lack of control over their work
  • Be transparent; share knowledge
  • Establish systems or support from senior staff
  • Let employees know they are valued
  • Create equitable engaging training to keep up to date
  • Foster healing and recovery for healthcare providers
  • Approach care from an honest, open, empathetic stance
  • Encourage healthcare professionals to invest in patients

The satisfaction of the patients is largely dependent upon the healthcare workforce they encounter in adverse situations.

The perceptions of patients are key to acknowledge as it influences healthcare funding as we head into 2022. KFF offers an overview and funding facts on Medicare spending, showing that Medicare was 15% of the total federal spending in 2018 which totaled $605 billion; further, Medicare spending is projected to rise to 18.3% percent from 2019 to 2029, increasing spending to $1.3 trillion in 2029. By enhancing the well-being of healthcare workers, hospitals will be better able to retain and recruit healthcare workers, provide quality care, increase customer satisfaction, and plan to respond to future public health threats.

Here at RBT CPAs, we understand the diverse and complicated world of healthcare. Our team of healthcare experts brings industry expertise in reimbursement, regulatory compliance and audit, accounting, and tax services. We will continue to keep you notified of timely news that matters to you and your team, but if you’d like to connect and receive individualized services, please contact us today. If you would like to submit feedback or topic ideas for future articles our team produces, please feel free to contact us at TLideas@rbtcpas.com.

Sources: News-Medical, News-Medical, CMS, CMS, Relias, AMA, News-Medical, KFF