Tips to Battling Holiday Stress

Did you know that 88% of Americans report feeling stressed at some point during the holidays. During this episode of Myra’s Minutes, we share tips on how to battle holiday induced stress this season.

You can view this short video here. 

Is It Time to Update Your Employee Appearance Policy?

As a courtesy, Fisher & Phillips LLP has provided a checklist of items to consider when revising your employee appearance policy and dress code – an especially timely topic given the evolving nature of employer expectations in this area.

Evolving Workplace Expectations and Standards

Pandemic prompted changes. Many workplaces have become more casual in recent years, and the COVID-19 pandemic accelerated this movement. Employers and co-workers alike probably don’t mind when a cat, dog, or child occasionally makes an appearance in a Zoom call, and they accept that many employees on those calls are wearing sweatpants with their camera-ready dress shirt. Moreover, many employers that want workers to return to the office have offered a variety of incentives, including a relaxed dress code.

What does this mean for your appearance standards?

These changes should motivate you to think about how to strike a balance between employee comfort and the standards of professionalism for your particular company culture and industry. Every workplace is different, but in general, you should consider the following questions:

_____	Will you create a general policy simply requiring employees to look professional and well-groomed? Or do you want to be more specific?
_____	Will you require customer-facing employees to dress more professionally or formally than those who only interact with co-workers — whether in person or on camera?
_____	Will you create a separate policy for Zoom meetings that may be more relaxed than your in-person appearance policy?
_____	Do you want to be more specific about what attire is unacceptable in the office or on Zoom? For example, are jeans and a t-shirt allowed? What about baseball caps, sleeveless shirts, or hooded sweatshirts? Just be sure to review such policies for compliance with the workplace laws discussed in more detail below.

Hairstyle equity. In addition to pandemic-related changes over the last few years, calls for social justice led many jurisdictions to pass laws combating workplace racial bias based on hairstyle. In fact, 19 states and many localities have passed a version of the CROWN Act, which prohibits employers from discriminating against employees and job applicants based on natural or protective hairstyles. Natural hair has not been treated with chemicals that alter color or texture — such as bleach or straightener. Protective hairstyles — such as braids, locs, twists, or bantu knots — tuck the ends of the hair away to protect from sun, heat, and other damage.

Racial discrimination based on hairstyles is a part of everyday life for many Black adults, according to a study by the CROWN Coalition — which was founded by Dove, National Urban League, Color of Change, and Western Center on Law and Poverty. Moreover, a 2019 Dove CROWN study found that Black women were 1.5 times more likely to be sent home from work because of their hair and 30% more likely to be made aware of a formal workplace appearance policy than their co-workers.

In light of laws banning hairstyle bias and to align with your efforts to be inclusive, you’ll want to consider the following about your appearance policy:

_____	Is the policy fairly and equitably applied to hairstyles regardless of race and ethnicity?
_____	Are your policies culturally and ethnically inclusive?
_____	Do you require employees to appear professional and well-groomed without creating hairstyle standards that unfairly restrict natural or protective hairstyles?
_____	Are your standards based on a bona fide occupational qualification (BFOQ) that is reasonably necessary to the normal operation of your business or enterprise? For example, certain employees who work with food may have to wear hair or beard coverings or tie their hair back for safety and hygiene reasons.

Reasonable accommodations and other legal considerations. While the COVID-19 pandemic and new CROWN Act requirements may prompt you to update your appearance policy and dress code, don’t forget to review your standards for compliance with other established workplace laws. Consider the following questions:

_____	Do you have a process in place to review accommodation requests? You may need to explore reasonable accommodations based on an employee’s religious practice or medical condition.
_____	For example, does your policy ban hats and other head coverings? If so, you may need to accommodate a Muslim employee who wears a hijab.
_____	Do you have a policy banning facial hair? If so, you may need to accommodate an employee with a skin condition — like Pseudofolliculitis Barbae — or a religious reason for growing a beard.
_____	If an accommodation does not seem right due to your unique business needs, have you discussed with your employment law counsel the possibility of an undue hardship exception for the business?
_____	Is your appearance policy gender-neutral? Without identifying a BFOQ, you shouldn’t create policies that cause greater burdens for employees of one gender than another.
_____	Further, have you considered refraining from setting different standards based on gender altogether unless there’s a BFOQ — particularly in light of the 2020 SCOTUS decision in Bostock v. Clayton County? In that case, the Supreme Court held that Title VII of the Civil Rights Act shields workers from discrimination based on gender identity.
_____	Have you considered all applicable state and local laws that may specifically address gender identity and workplace policies?
_____	Does your policy align with the latest guidance from the National Labor Relations Board (NLRB)? Be sure to consistently enforce any rules prohibiting employees from wearing clothing with logos, political statements, or social justice messages.
_____	Are you aware of the NLRB’s current position on employees wearing union insignia — on items such as buttons and t-shirts? An employer needs to show special circumstances that justify its actions when it interferes with its employees’ right to display such insignia.
_____	Are there any safety concerns that should be reflected in your dress code? You may want to relax your appearance policy, but you should still consider whether to continue following some rules for safety reasons — either as a best practice or because it’s required by law.
_____	For example, will you require certain workers to wear closed-toe shoes? Are there Occupational Safety and Health Administration (OSHA) rules that you need to follow for certain jobs? If so, you’ll want to ensure compliance.
_____	Did you review your policies with legal counsel? Because so many evolving areas of law may impact your employee appearance policy and dress code, it’s a good idea to have experienced legal counsel review your standards for compliance before communicating any updates to your employees.

Conclusion

Recent workplace shifts mean that it’s time to review your employee appearance standards and dress code to ensure they are fair and inclusive, as well as compliant with the latest legal developments. Keep in mind that consistency is key.

FL Minimum Wage Increase in September 2023

Reminder- Florida’s minimum wage will increase to $12.00 per hour on September 30, 2023. The direct wage for tipped employees will also increase to $8.98 per hour. Be sure to update your minimum wage poster(s) before September 30, 2023. Please let us know if you need copy of the updated poster(s).

What is an EAP?

During this episode of Myra’s Minutes, we will explain what an Employee Assistance Program (EAP) is and well as the valuable free tools available to employees to help deal with problems they encounter both at work and home.

Did you know that 70% of employees who use an EAP service report that their stress levels improve?

You can view this short video here. 

IRS Releases ACA Shared Responsibility Affordability Percentage for 2024

The IRS recently issued Revenue Procedure 2023-29, which significantly decreases the affordability threshold for ACA employer mandate purposes to 8.39% for plan years beginning in 2024. The new 8.39% level marks by far the lowest affordability percentage to date.

The affordability percentages apply for plan years beginning in the listed year. A calendar plan year will therefore have the 8.39% affordability threshold for the plan year beginning January 1, 2024.

The ACA employer mandate rules apply to employers that are “Applicable Large Employers,” or “ALEs.” In general, an employer is an ALE if it (along with any members in its controlled group) employed an average of at least 50 full-time employees, including full-time equivalent employees, on business days during the preceding calendar year.

There are two potential ACA employer mandate penalties that can impact ALEs:

a) IRC §4980H(a)—The “A Penalty”

The first is the §4980H(a) penalty—frequently referred to as the “A Penalty” or the “Sledge Hammer Penalty.” This penalty applies where the ALE fails to offer minimum essential coverage to at least 95% of its full-time employees in any given calendar month.

The 2024 A Penalty is $2,970 annualized multiplied by all full-time employees (reduced by the first 30). It is triggered by at least one full-time employee who was not offered minimum essential coverage enrolling in subsidized coverage on the Exchange.

The “A Penalty” liability is focused on whether the employer offered a major medical plan to a sufficient percentage of full-time employees—not whether that offer was affordable (or provided minimum value).

b) IRC §4980H(b)—The “B Penalty”

The second is the §4980H(b) penalty—frequently referred to as the “B Penalty or the “Tack Hammer Penalty.” This penalty applies where the ALE is not subject to the A Penalty (i.e., the ALE offers coverage to at least 95% of full-time employees).

The B Penalty applies for each full-time employee who was:

1. not offered minimum essential coverage,
2. offered unaffordable coverage, or
3. offered coverage that did not provide minimum value.

Only those full-time employees who enroll in subsidized coverage on the Exchange will trigger the B Penalty. Unlike the A Penalty, the B Penalty is not multiplied by all full-time employees.

In other words, an ALE who offers minimum essential coverage to a full-time employee will be subject to the B Penalty if:

1. the coverage does not provide minimum value or is not affordable (more below); and
2. the full-time employee declines the offer of coverage and instead enrolls in subsidized coverage on the Exchange.

The 2024 B Penalty is $4,460 annualized per full-time employee receiving subsidized coverage on the Exchange.

Handbooks Need Revision Following NLRB Ruling

Many employer handbooks and policies likely should be reviewed and revised following a landmark Aug. 2 ruling by the National Labor Relations Board (NLRB), Stericycle.

“This ruling, in a word, is huge,” said David Pryzbylski, an attorney with Barnes & Thornburg in Indianapolis. “This decision may invalidate countless workplace rules maintained by private-sector employers—whether they are unionized or not. It applies to all companies covered by the National Labor Relations Act [NLRA], which is the vast majority of employers in America.”

The NLRA does not apply to federal or state governmental units, railroads or airlines.

Employers need to create documentary evidence of the justification for their work rules before an unfair labor practice charge is filed, recommended Harry Johnson III, an attorney with Morgan Lewis in Los Angeles and former NLRB member.

New Standard

In Stericycle, an administrative law judge found that the employer violated the NLRA by maintaining certain rules for its employees that addressed personal conduct, conflicts of interest and confidentiality of harassment complaints. The NLRB announced a new standard for whether work rules violate the NLRA and sent the case back to the judge to consider the ruling in light of the new standard.

Under that standard, if an employee could reasonably interpret the work rule to have a coercive meaning, the NLRB general counsel would have met her burden to prove that the rule has a reasonable tendency to chill employees from exercising their NLRA rights. The general counsel, currently Jennifer Abruzzo, is independent from the board and responsible for the investigation and prosecution of unfair labor practice cases under the NLRA.

The employer’s intent in maintaining a work rule is immaterial, the NLRB wrote. The board instead clarified it will interpret the rule from the perspective of an employee who is subject to the policy, economically dependent on the employer and contemplates engaging in protected concerted activity.

Concerted activity includes talking with one or more co-workers about wages and benefits or other working conditions, circulating a petition asking for better hours, participating in a concerted refusal to work in unsafe conditions, openly talking about pay and benefits, and joining with co-workers to talk directly to the employer, an agency or the media about problems in the workplace, according to the NLRB.

It’s hard to imagine the general counsel won’t be able to prove that a rule has a reasonable tendency to chill employees from exercising their NLRA rights, said Phil Wilson, president and general counsel with the Labor Relations Institute, a labor and employee relations consulting firm in Broken Arrow, Okla.

If the general counsel provides such proof, the rule is presumptively unlawful. However, the employer may counter the presumption by proving that the rule advances a legitimate and substantial business interest and that the employer can’t advance that interest with a more narrowly tailored rule. If the employer proves this, the work rule will be found lawful.

However, “with little actual guidance about the meaning of the phrases above, needless to say, it is an incredibly uphill battle if an employer finds itself trying to rebut the presumption,” said Jason Reisman, an attorney with Blank Rome in Philadelphia.

In addition, the Stericycle opinion discarded previous NLRB decisions holding that certain types of policies were inherently lawful, regardless of the precise language in which the policy is expressed, in favor of evaluation of each challenged policy on a case-by-case basis, said Peter Spanos, an attorney with Taylor English Duma in Atlanta. Policies that are no longer deemed by the board always lawful to maintain are investigative-confidentiality rules, nondisparagement rules and rules prohibiting outside employment.   

“Employee handbooks and policies that were adopted or revised based on prior guidance from the NLRB may now be subject to challenge,” he said.

The decision probably will be appealed. The appellate process can take many months or even years, Pryzbylski added. “In the meantime, the board will be enforcing this new standard, so employers face the risk of having their policies invalidated if they do not revisit them to ensure they are drafted in a compliant manner,” he said. “To the extent they are found to have unlawful rules, it could result in backpay awards in the event an employee is terminated pursuant to such a rule, have negative effects on a union election outcome, as well as other penalties.”

Plus, in most cases, the NLRB does not follow a federal appeals court ruling outside of that court’s jurisdiction until the Supreme Court weighs in, if it does. “So, that may favor companies taking a fresh look at their policies sooner rather than later,” Pryzbylski said.

Employer Policy Implications

Examples of policies that likely need to be reviewed and rewritten to be aligned with the new board standard, according to Spanos, include work rules:

• Restricting employees’ use of social media.
• Restricting criticism, negative comments, and disparagement of the company’s management, products, or services.
• Promoting civility.
• Prohibiting insubordination.
• Requiring confidentiality of investigations and complaints.
• Restricting behaviors such as using cameras or recording devices in the workplace.
• Outlining rules for safety complaints.
• Restricting the use of company communication resources, such as email or Slack.
• Limiting the recording of meetings or the use of smartphones or other devices.
• Restricting meetings with co-workers or the circulation of petitions.
• Limiting comments to the media or government agencies.

All HR professionals should work with their labor counsel to audit current employment policies for compliance with the new standard and to keep up-to-date on board decisions that will apply the Stericycle standard in coming months.

The bottom line is that many policies will be under new and intense scrutiny by the NLRB, and employers should be aware of the new standard and review and update their policies accordingly.

Changes to I-9 Form Requirements as of Aug 1st

On August 1, 2023, U.S. Citizenship and Immigration Services (“USCIS”) will release a new version of Form I-9, Employment Eligibility Verification. Effective that same day, the Department of Homeland Security (“DHS”) has authorized a permanent optional alternative procedure to allow qualified employers to virtually inspect and verify identification documents to complete Section 2 of Form I-9. Virtual inspection that has been allowed for remote employees since 2020 had been set to expire July 31, 2023.

While DHS previously stated that remotely-verified forms would need to be reverified no later than August 30, 2023, the agency announced that employers do not need to complete the new Form I-9 (Rev. 08/01/23) for current employees who already have a properly completed Form I-9 on file, unless reverification applies after October 31, 2023. Additional details and clarification of “properly completed” will be provided when they become available.

According to the DHS, the alternative remote verification procedure will only be available at this time to qualified employers who are enrolled and participate in good standing in E-Verify. Employers who are already enrolled in E-Verify are not required to reenroll in E-Verify to use the alternative procedure. Also according to DHS, E-Verify has the capacity to support an increased number of employers who may choose to newly enroll in E-Verify to use the alternative procedure. Employers who do not qualify may continue to use authorized representatives where in-person inspection is not feasible.

Qualified employers who choose to remotely verify identification documents after August 1, 2023 must follow the below procedure:

1. The employee must first transmit a copy of the document(s) to the employer.
2. The employer must examine copies (front and back, if the document is two-sided) of the documents to ensure that the documentation presented reasonably appears to be genuine.
3. The employee must then present the same documents during a live video interaction with the employer.
4. The employer must check the corresponding box on the Form I-9 (Rev. 08/01/23) that an alternative procedure was used to examine documentation to complete Section 2 or for reverification, as applicable.
5. The employer must retain a clear and legible copy – either paper or electronic versions — of the documentation (front and back, if the documentation is two-sided), of all documents examined for as long as the employee works for the employer and for a specified period after employment has ended.

 

Starting on August 1, 2023, employers may download the new Form I-9 (Rev. 08/01/23) from the USCIS website. The prior version of Form I-9 (Rev. 10/21/19) will no longer be valid after October 31, 2023.

 

According to the USCIS, the forthcoming new version of Form I-9 will have significant changes to the form and its instructions, including a checkbox to indicate that an employee’s Form I-9 documentation was examined virtually. Other updates to Form I-9 include:

• Reduced Sections 1 and 2 to a single-sided sheet. No previous fields were removed. Rather, multiple fields were merged into fewer fields when possible.
• Moved the Section 1 Preparer/Translator Certification area to a separate, standalone supplement (Supplement A) that employers can provide to employees when necessary.
• Moved the Section 3 Reverification and Rehire area to a separate, standalone supplement (Supplement B) that employers can print if or when rehire occurs or reverification is required.
• Removed use of “alien authorized to work” in Section 1 and replaced it with “noncitizen authorized to work” as well as clarified the difference between “noncitizen national” and “noncitizen authorized to work.”
• Ensured the form can be filled out on tablets and mobile devices.
• Removed certain features to ensure the form can be downloaded easily. This also removes the requirement to enter N/A in certain fields.
• Updated the notice at the top of the Form I-9 that explains how to avoid discrimination in the Form I-9 process.
• Revised the Lists of Acceptable Documents page to include some acceptable receipts as well as guidance and links to information on automatic extensions of employment authorization documentation.

 

Updates to the Form I-9 instructions include:

• Reduced length of instructions from 15 pages to 8 pages.
• Added definitions of key actors in the Form I-9 process.
• Streamlined the steps each actor takes to complete their section of the form.
• Added instructions for use of the new checkbox for employers who choose to examine Form I-9 documentation under an alternative procedure.
• Removed the abbreviations charts and relocated them to the M-274, Handbook for Employers: Guidance for Completing Form I-9. An updated M-274 will likely be released along with the revised Form I-9, but it is not yet available.

Reminder: Update Your EEOC Poster and Start Complying with the Pregnant Workers Fairness Act

The Pregnant Workers Fairness Act (PWFA) goes into effect on June 27, 2023. The PWFA requires employers to post a notice describing the various protections under the new law.  On June 27^th, employers should remove their old EEOC “Know Your Rights” posters and replace them with the updated version. Please let us know if you need a copy of the updated English or Spanish posting to comply with the PWFA.

The 10 Things All Employers Must Include in Any Workplace AI Policy

Whether your organization has deployed a generative AI tool for your employees or hasn’t (yet) hopped on the bandwagon, the time is now for you to create a workplace policy governing the use of the technology. Many organizations are exploring ways their workforces can harness the revolutionary advances in productivity, efficiency, and creativity that generative AI (GenAI) products like ChatGPT, Google’s Bard, or Microsoft’s Bing can bring. And, even if you aren’t doing the same, your employees almost certainly are. But how can you do so in a responsible way? A first step is developing a workplace GenAI policy. Read on for the 10 things you should include.

First Things First: What is GenAI?

Recent advances in GenAI, kicked off most prolifically by the release of ChatGPT and soon thereafter joined by Bard and the reformulated Bing, have captured the attention of a broad audience. Almost immediately, employees and employers alike began thinking about the ways the technology can be used in the workplace, seemingly limited only by our imaginations. How is this different, however, than other forms of AI which have been around for years?

You’ve probably been living and working with some form of AI for some time now. Does your company have any sort of chatbot providing answers to simple questions about where to find a resource? No doubt you have an auto-complete feature when you type into your email platform. Those are all examples of artificial intelligence – just in rudimentary form.

Unlike this prior technology, GenAI is able to generate original human-like output and expressions in addition to describing or interpreting existing information. In other words, it appears to “think” and respond like a human. However, GenAI is limited by the data upon which it was trained, and will not have the judgment, strategic thinking, or contextual knowledge that a human does. These and other technological limitations and risks are why having a sound GenAI policy is so important.

The 10 Components Your GenAI Policy Should Include

While each company should customize a GenAI policy to suit its own needs and priorities, there are 10 topics to consider at a bare minimum. 

1. Outline the Policy’s Purpose and Scope. The first thing your policy should include is a description of its purpose and scope.
   • Generally, the purpose of the policy would be to provide guidelines for the organization’s development, implementation, use, and monitoring of GenAI in the workplace.
   • The scope should clearly tell your employees which areas are covered – and here’s where you need to be very clear. If your organization does not provide any GenAI products for your employees, you still need to make clear that the policy covers the use of any third-party or publicly available GenAI tool, such as ChatGPT, Bard, Bing, DALL-E, Midjourney, and other similar applications that mimic human intelligence to generate answers, work product, or perform certain tasks. And, if you do supply your workers with a GenAI product, you should make sure your policy covers appropriate usage with specific circumstances kept in mind.
2. Maintain Data Privacy and Security. Data privacy and security is a critical component of any GenAI policy, particularly given the strict data privacy laws that exist and are developing across the country (and internationally). Your policy should create safeguards to protect the data inputted into any GenAI technology, addressing data collection, storage, and sharing. At a minimum, you should prohibit your employees from entering private or personal information into any GenAI platform.
3. Uphold Company Confidentiality. You will also want to ensure that your company’s most important data – trade secrets, private information, PII of your employees and other third parties, confidential data, sensitive matters, etc. – are kept far away from GenAI. This will not only help you avoid embarrassing or damaging situations, but could help you uphold and defend the confidential nature of this information if you ever find yourself in trade secrets litigation.
4. Ensure Your Commitment to Diversity is Not Compromised. GenAI has the capacity to provide information that violates not only your company’s strong diversity goals but also legal anti-discrimination standards. For this reason, you should plainly state that information received from GenAI needs to be double-checked using reasoned human judgment to ensure it does not run afoul of your company’s commitment to diversity.
5. Prohibit Employment-Based Decisions Aided by GenAI. Related to the previous point, you should clearly state that GenAI tools should not be used to make or help you make employment decisions about applicants or employees. This includes recruitment, hiring, retention, promotions, transfers, performance monitoring, discipline, demotion, terminations, or other decisions. Of course, if you have deployed a GenAI tool to help you navigate human resources activity, you can allow such use – so long as you are confident that your policies surrounding the use of that specific tool uphold legal principles (including any relevant state laws) and your highest company standards.
6. Prevent Copyright or Other Theft Concerns. The danger always exists that information provided from GenAI platforms (including image generators like DALL-E 2 and Midjourney) could include details from copyrighted or other protected sources. If your employees use a GenAI tool to generate content for company use that happens to include information from a protected source, you could find yourself in legal hot water. Make sure your employees know not to pass off any information or content received from GenAI as their own without double-checking sources. They should use GenAI as an idea generator, not as a replacement for content creation.
7. Outline Best Practices. The inherent limitations related to GenAI in its current form should lead you to outline best practices that should be followed whenever your employees use the technology to aid their work. Some examples:
   • Because GenAI is prone to providing hallucinations and outdated answers, you should require your workers to confirm any information received before relying on it in any capacity.
   • There is always risk of a data breach involving any GenAI provider. While your workers might think they can input any question into the system with complete anonymity, they should be warned to treat any information provided into any GenAI platform as if it will go viral on the Internet –with their name and your company’s identity along with it.
   • Your company’s supervisors should want to know when – and to what extent – GenAI was used to help complete a task. For that reason, you might recommend that employees disclose when they are using the technology and the extent it aided the creation of any content they develop.
8. Be Clear About Consequences. As with any company policy, you should inform your employees that they could face repercussions should they violate any of its tenets. Let them know they could face disciplinary action – up to and including immediate termination, and possibly legal action – should they violate the policy. The policy should also direct employees to report potential violations they learn about to their supervisor or to HR.
9. Include a Disclaimer. Due to the broad reach of the National Labor Relations Act – even over companies that don’t have a unionized workforce – you need to make sure that you offer protections for behavior that has been upheld as protected by the NLRB and courts. Work with your legal counsel to create a disclaimer that clearly states your policy is not intended to interfere with, restrain, or prevent employee communications regarding the rights protected by federal labor law.
10. Input From Across the Spectrum. Finally, make sure you include multi-disciplinary input from stakeholders across the organization to ensure your policy is comprehensive, effective, and realistic. Obvious stakeholders include members of your regulatory, compliance, IT, DEI, and legal departments.

What’s Next?

Once you publish your GenAI policy, your work is not over – it’s just beginning. Besides the all-important work of training your workforce on the policy parameters and ensuring continued and consistent enforcement, you should use the creation of a policy as the right time to establish a framework for GenAI governance and oversight.

Please let us know if you would like a copy of a complimentary GenAI policy provided courtesy of Fisher Phillips LLP.

PCORI Filing Due to IRS by July 31st

An “old faithful” reporting requirement deadline is right around the corner: the Patient-Centered Outcomes Research Institute (PCORI) filing and fee. The Affordable Care Act imposes this annual per-enrollee fee on insurers and sponsors of self-funded medical plans to fund research into the comparative effectiveness of various medical treatment options.

The due date for the filing and payment of PCORI fee is July 31 for required policy and plan years that ended during the 2022 calendar year. For plan years that ended Jan. 1, 2022 – Sept. 30, 2022, the fee is $2.79 per covered life. For plan years that ended Oct. 1, 2022 – Dec. 31, 2022 (including calendar year plans that ended Dec. 31, 2022), the fee is calculated at $3.00 per covered life.

Insurers report on and pay the fee for fully insured group medical plans. For self-funded plans, the employer or plan sponsor submits the fee and accompanying paperwork to the IRS. Third-party reporting and payment of the fee (for example, by the self-insured plan sponsor’s third-party claim payor) is not permitted.

An employer that sponsors a self-insured health reimbursement arrangement (HRA) along with a fully insured medical plan must pay PCORI fees based on the number of employees (dependents are not included in this count) participating in the HRA, while the insurer pays the PCORI fee on the individuals (including dependents) covered under the insured plan. Where an employer maintains an HRA along with a self-funded medical plan and both have the same plan year, the employer pays a single PCORI fee based on the number of covered lives in the self-funded medical plan and the HRA is disregarded.

PCORI fee reporting and payment

The IRS collects the fee from the insurer or, in the case of self-funded plans, the plan sponsor in the same way many other excise taxes are collected. Although the PCORI fee is paid annually, it is reported (and paid) with the Form 720 filing for the second calendar quarter (the quarter ending June 30). Again, the filing and payment is due by July 31 of the year following the last day of the plan year to which the payment relates (i.e. filling for the 2022 PCORI fee is due by July 31, 2023)

Calculating the PCORI fee

IRS regulations provide three options for determining the average number of covered lives: actual count, snapshot and Form 5500 method. 

Actual count: The average daily number of covered lives during the plan year. The plan sponsor takes the sum of covered lives on each day of the plan year and divides the number by the days in the plan year.

Snapshot: The sum of the number of covered lives on a single day (or multiple days, at the plan sponsor’s election) within each quarter of the plan year, divided by the number of snapshot days for the year. Here, the sponsor may calculate the actual number of covered lives, or it may take the sum of (i) individuals with self-only coverage, and (ii) the number of enrollees with coverage other than self-only (employee-plus one, employee-plus family, etc.), and multiply by 2.35. Further, final rules allow the dates used in the second, third and fourth calendar quarters to fall within three days of the date used for the first quarter (in order to account for weekends and holidays). The 30th and 31st days of the month are both treated as the last day of the month when determining the corresponding snapshot day in a month that has fewer than 31 days.

Form 5500: If the plan offers family coverage, the sponsor simply reports and pays the fee on the sum of the participants as of the first and last days of the year (recall that dependents are not reflected in the participant count on the Form 5500). There is no averaging. In short, the sponsor is multiplying its participant count by two, to roughly account for covered dependents.

The U.S. Department of Labor says the PCORI fee cannot be paid from ERISA plan assets, except in the case of union-affiliated multiemployer plans. In other words, the PCORI fee must be paid by the plan sponsor; it cannot be paid in whole or part by participant contributions or from a trust holding ERISA plan assets. The PCORI expense should not be included in the plan’s cost when computing the plan’s COBRA premium. The IRS has indicated the fee is, however, a tax-deductible business expense for sponsors of self-funded plans.

Although the DOL’s position relates to ERISA plans, please note the PCORI fee applies to non-ERISA plans as well and to plans to which the ACA’s market reform rules don’t apply, like retiree-only plans.

How to file IRS Form 720

The filing and remittance process to the IRS is straightforward and unchanged from last year. On Page 2 of Form 720, under Part II, the employer designates the average number of covered lives under its “applicable self-insured plan.” As described above, the number of covered lives is multiplied by the applicable per-covered-life rate (depending on when in 2021 the plan year ended) to determine the total fee owed to the IRS.

The Payment Voucher (720-V) should indicate the tax period for the fee is “2nd Quarter.”

Failure to properly designate “2nd Quarter” on the voucher will result in the IRS’ software generating a tardy filing notice, with all the incumbent aggravation on the employer to correct the matter with IRS.

You missed a past PCORI payment. Now what?

An employer that overlooks reporting and payment of the PCORI fee by its due date should immediately, upon realizing the oversight, file Form 720 and pay the fee (or file a corrected Form 720 to report and pay the fee, if the employer timely filed the form for other reasons but neglected to report and pay the PCORI fee). Remember to use the Form 720 for the appropriate tax year to ensure that the appropriate fee per covered life is noted.

The IRS might levy interest and penalties for a late filing and payment, but it has the authority to waive penalties for good cause. The IRS’s penalties for failure to file or pay are described here.

The IRS has specifically audited employers for PCORI fee payment and filing obligations. Be sure, if you are filing with respect to a self-funded program, to retain documentation establishing how you determined the amount payable and how you calculated the participant count for the applicable plan year.