If you are an employee in Washington state, you may be wondering what are the leave of absence rules that apply to your situation. A leave of absence is an absence from work mutually and voluntarily agreed upon by you and your employer or a collective bargaining agent, or leave to which you are entitled under federal or state law, where the employer-employee relationship is continued and you will be reinstated in the same or similar job when the leave expires. There are different types of leave that may be available to you depending on your circumstances, such as:

- Vacation Leave: In Washington, employers are not required to provide employees with vacation benefits, either paid or unpaid. However, if an employer chooses to do so, it must comply with its own established policy or employment contract.
- Sick Leave: Washington law requires employers to provide employees with paid sick leave. Employees must be allowed to accrue at least one hour of paid sick leave for every 40 hours worked. Employees may use their accrued, unused paid sick leave for various authorized purposes, such as caring for themselves or their family members, dealing with domestic violence issues, or when their workplace or child's school is closed for health reasons.
- Holiday Leave: In Washington, employers are not required to provide employees with holiday leave benefits, either paid or unpaid. However, if an employer chooses to do so, it must comply with its own established policy or employment contract.
- Jury Duty Leave: In Washington, employers must provide employees with unpaid jury duty leave. Employers may not discharge or threaten to discharge an employee for serving as a juror. Employees may not waive their right to jury duty leave.
- Voting Leave: In Washington, employers must provide employees with up to two hours of paid voting leave if they do not have sufficient time outside of working hours to vote. Employees must request voting leave before election day and show proof of voting if requested by the employer.
- Bereavement Leave: In Washington, employers are not required to provide employees with bereavement leave benefits, either paid or unpaid. However, if an employer chooses to do so,
it must comply with its own established policy or employment contract .
- Family and Medical Leave: In Washington, there are two laws that provide employees with family and medical leave benefits: the federal Family and Medical Leave Act (FMLA) and the state Paid Family and Medical Leave (PFML) program. The FMLA applies to employers with 50 or more employees and provides eligible employees with up to 12 weeks of unpaid job-protected leave per year for various qualifying reasons such as childbirth, adoption, foster care placement, serious health condition of self or family member, or military exigency . The PFML applies
to most workers in Washington state and provides eligible employees with up to three months of partial wage replacement per 12 months,
with some possibly entitled to up to 16 weeks.

Employees in Washington who use this paid leave may receive up to 90% of their weekly wages or up to $1,000 per week. Qualifying events can include: birth or placement of a new child into a family, recovery from a serious illness or injury, treatment of a chronic health condition,
inpatient treatment for substance abuse or mental health, taking care of a family member with a serious health condition, and certain military events .

These are some of the main types of leave that may be available to you as an employee in Washington state. However, there may be other types of leave that apply depending on your specific situation. You should always check with your employer about their policies and procedures regarding leaves of absence before taking any action. You should also consult a legal professional if you have any questions about your rights and obligations under federal and state laws.
 

If you're wondering why your health insurance premiums are increasing next year, you're not alone. Many Americans are facing higher costs for their coverage in 2023, and there are several reasons behind this trend.

One of the main factors that affect health insurance prices is the cost of medical care. According to a report by Health Care Cost Institute, health care spending per person grew by 4.2% in 2019, the highest rate since 2014. This was driven by higher prices for hospital services, physician services, and prescription drugs.

Another factor that influences health insurance prices is the demand for health care services. The COVID-19 pandemic has had a significant impact on how people use health care, both during and after the crisis. Some people may have delayed or avoided preventive care or elective procedures due to fear of exposure or lack of access. Others may have experienced long-term health complications from COVID-19 that require ongoing treatment. These changes in utilization patterns can affect how insurers estimate their risk and set their premiums.

A third factor that affects health insurance prices is the availability of subsidies and tax credits. The American Rescue Plan Act (ARPA) of 2021 expanded eligibility and increased amounts for premium tax credits for people who buy health insurance through the Marketplace. This means that more people can qualify for financial assistance and pay lower premiums than before. However, this also means that insurers have to adjust their rates to account for the higher federal spending on subsidies.

The impact of these factors on health insurance prices may vary depending on where you live, what type of plan you choose, and your income level. To get an estimate of how much you'll pay for health insurance in 2023, you can use tools like HealthCare.gov's plan preview or ValuePenguin's average cost calculator. You can also compare different plans and options to find one that meets your needs and budget.
 

WA SB 5546 requires that all individual and insured medical plans cap member cost for insulin at $35 per month in 2023.  This will impact plans as they are purchased or renewed in 2023.  Prior to this change, insulin was capped at $100 per month instead.  Great news for the many diabetics in Washington state!

Each year, small group insurance carriers in Washington state must submit their requested rate increases to Washington’s Office of the Insurance Commissioner (OIC).  Small group insurance plans are for employers who had 50 or fewer employees on average during the calendar year prior to the effective (or renewal) date of the plan.  

Unfortunately, there are more two digit increases requested for 2023 than in 2022.  Why? The pandemic.  Many insurance companies are asking for higher rate increases on renewals due to lagging COVID-related claims, COVID test kits, a higher medical and prescription drug trend, and overall inflation.  Additional factors impacting small group rates include:

• Some care deferred during the pandemic returned - Healthcare spending by employers in 2021 was lower than expected, in large part because of the deferral of care as a result of the pandemic. 
• COVID costs are likely to persist - The costs of testing for COVID, treating patients and administering vaccinations for the disease likely will continue into 2023.
• The mental health and substance use crises show no signs of waning - The pandemic substantially increased demand for mental health services. Increased substance use also likely will increase healthcare spending in 2023.
• Population health worsened during the pandemic - Poor pandemic-era health behaviors such as lack of exercise, poor nutrition, increased substance use and smoking has led to an increase in healthcare spending and medical trend.  Medical trend is defined as the projected percentage increase in the cost to treat patients from one year to the next, assuming benefits remain the same.

There are two insurance companies who asked for double digit increases to their small group, age-banded rates:  Kaiser of WA (+10.2%) and Premera Blue Cross of WA (+11.5%).  These increase requests are based upon each carrier's gain or loss at the end of 2021.  Kaiser has a $10.3M deficit and Premera's was $1.6M.

It will take a few months for the OIC to review and approve the requested increases, but if you're with Kaiser of WA or Premera for small group, it may be time to shop around.  Need help? Contact us. We can help find alternative affordable plans.

A quick update on the WA Cares LTC Act.  On 1/27/2022, Governor Jay Inslee signed into law two bills, House Bill 1732 and House Bill 1733, which became effective at signing. These new bills will delay and make significant changes to the Washington Cares Fund.

Employers should cease collecting premiums for the Washington Cares Fund immediately and refund any premiums that have been deducted in accordance with HB 1732 which requires refunds to be made within 120 days of the collection of the premiums.

Employers should continue to monitor the WA Cares Fund for further developments at the following link: https://wacaresfund.wa.gov/.  We will continue to provide updates on our website's blog located at https://pnwisol.com/hot-topics1.
 

On Friday, December 17, 2021, Governor Inslee, as well as Senate Majority Leader Andy Billig and House Speaker Laurie Jinkins, issued statements implementing a delay in the WA Cares program. Specifically: 

• The statements “strongly encourage” employers not to withhold the premium, which would have otherwise gone into effect January 1, 2022.
• The Washington Employment Security Department will not collect the employee premiums from employers before April 2022, at the earliest.
• Washington State will not assess penalties or interest on employers who do not withhold the premium from employees’ wages.

Photo by Brett Jordan on Unsplash
 

FINALLY!

The Internal Revenue Service (IRS) finally announced the official 2022 Flexible Spending Account (FSA), commuter, and adoption limits. Here are the newly released contribution limits:

NEW CONTRIBUTION LIMITS

• 2022 Healthcare FSA/Limited Purpose FSA: $2,850
• 2022 FSA carryover: $570
• 2022 Dependent Care FSA: $5,000 (family); $2,500 (married filing separately)
• 2022 Commuter (parking and transit): $280 per month
• 2022 Adoption limit: $14,890

YOUR FLEXIBLE SPENDING ACCOUNTS
The 2022 healthcare FSA contribution limit is an increase of $100 from the 2021 healthcare FSA contribution limit ($2,750). The carryover limit is an increase of $20 from the 2021 limit ($550).

The 2022 Dependent Care FSA contribution limits decreased from $10,500 in 2021 for families and $5,250 for married taxpayers filing separately. The 2021 Dependent Care FSA limits came in response to the COVID-19 pandemic as a temporary relief to working parents. Both healthcare FSAs and Dependent Care FSAs are versatile healthcare savings vehicles that allow individuals to receive tax benefits when they spend funds on eligible expenses.

Overall, there are four general types of FSAs to know about:

1. Healthcare FSA: Can be used for eligible medical expenses, including deductibles, copays, and coinsurance.
2. Post-deductible FSA: Can be used for certain eligible medical expenses once a minimum deductible has been met. Can be used in conjunction with a Health Savings Account (HSA).
3. Limited-purpose FSA: Can be used to pay for eligible vision and dental expenses. Can be used in conjunction with an HSA.
4. Dependent Care FSA: Can be used to pay for eligible expenses related to tax dependents, including day care, preschool, elderly care, and other types of dependent care. This type of FSA can only be used if the dependent care is necessary for you or your spouse to work, look for work, or to attend school full time.

 WHAT TO KNOW ABOUT ROLLOVER FUNDS 
In general, FSA funds are a use-it-or-lose-it account. However, employers may offer employees one of two options:

1. Grace period: Allows for a maximum of an extra 2.5 months to use FSA funds for eligible expenses incurred in the following plan year.
2. Carryover: Allows accountholders to carry over a certain amount (for 2022, the limit is $570) that can be used in the following year.

Employers can offer one of these options but not both, and neither option is required. To learn more contact us for more information.

DETAILS ON COMMUTER LIMITS
For 2022, the commuter contribution limits have increased $10 more per month than the 2021 contribution limit ($270).

If this plan is offered by the Employer, a commuter account allows you to set aside pre-tax funds to pay for your commute to work. For 2022, if you were to use both transit and parking, you could set aside up to $6,720 annually. Assuming a 30% effective tax rate that means you could potentially reduce your tax liability by more than $2,000. 

ADOPTION ASSISTANCE EXCLUSION AND ADOPTION CREDIT
The IRS also increased the Adoption Assistance Exclusion or Adoption Credit amounts to $14,890, an increase of $490 from 2021 ($14,400).
Parents who either adopted or tried to adopt a child may seek to claim the adoption credit on their individual tax returns. If a taxpayer’s employer helped with adoption expenses through a qualified adoption assistance program, the taxpayer may qualify to exclude that amount from their individual taxes.
 

401(k) Contribution Limit Increased to $20,500

The Internal Revenue Service (IRS) has released Notice 2021-61, which contains cost-of-living adjustments for 2022 that affect amounts employees can contribute to 401(k) plans and individual retirement accounts (IRAs). The employee contribution limit for 401(k) plans in 2022 has increased to $20,500, up from $19,500 for 2021 and 2020.

Other key limit increases include the following:

The employee contribution limit for SIMPLE IRAs and SIMPLE 401(k) plans is increased to $14,000, up from $13,500.
The limits used to define a “highly compensated employee” and a “key employee” are increased to $135,000 (up from $130,000) and $200,000 (up from $185,000), respectively.

Key limits that remain unchanged include the employee contribution limit for IRAs (remaining at $6,000) and the catch-up contribution limit for employees aged 50 and over who participate in 401(k), 403(b), most 457 plans and the federal government’s Thrift Savings Plan (remaining at $6,500).

Starting Jan. 1, 2022, Washington state law protects you from surprise or balance billing if you receive emergency care at any medical facility or when you're treated at an in-network hospital or outpatient surgical facility by an out-of-network provider. 

What is surprise or balance billing
Surprise billing happens because some types of medical providers, including anesthesiologists, radiologists, pathologists, and labs may not be contracted with your health insurer even though they provide services at a hospital or facility that is in your health plan’s provider network. So, in addition to your expected out-of-pocket costs, you also get a bill for the difference between what your insurer has agreed to pay that provider and the amount the provider billed for their services. 

The new Balance Billing Protection Act prevents people from getting a surprise medical bill when they receive emergency care from any hospital or if they have a scheduled procedure an in-network facility and receive care from an out-of-network provider. In this case, if an insurer and provider cannot agree on a price for the covered services, they go to arbitration and cannot bill the consumer for the amount in dispute.
 

What to do if you get a surprise bill
If you get a surprise medical bill for a service you had before Jan. 1, 2022, contact the provider or facility and tell them your concerns. See if you can get them to lower your bill. After Jan. 1, 2022, you cannot be surprise billed for certain services. If you get a surprise bill, contact the provider or facility and tell them you believe you've been wrongly billed. You can also file a complaint with the Washington Office of the Insurance Commisioner and they will investigate on your behalf. 
 

The law applies to most, but not all health plans 
The Balance Billing Protection Act applies to all state-regulated health plans and state and school employee benefit plans. Self-funded group health plans are not regulated by the state and must notify the WAOIC if they want to opt-in to the law and offer the protections to their enrollees.  

There are a number of new laws coming out of the Biden Administration which may impact you.  Centers for Medicare & Medicaid Services (CMS) provided a fact sheet regarding new ACA subsidies, with a Q&A section to help individuals understand how to obtain the new subsidies. To delve further in by county, see the Assistant Secretary for Planning and Evaluation (ASPE) data sets which break down the uninsured numbers by household income, age, etc.  

Health and Human Services (HHS) provided a fact sheet regarding new ACA subsidies, along with a table which shows the number of uninsured who will now be eligible in each state.

For additional information, refer to HR360 .