IRS Expands Preventive Care for HDHPs to Include Chronic Conditions

On July 17, 2019, the IRS released Notice 2019-45 to add care for a range of chronic conditions to the list of preventive care benefits that can be provided by a high deductible health plan(HDHP)without a deductible.
Individuals who are covered by an HDHP generally may establish and make contributions to a health savings account(HSA).To qualify as an HDHP, the plan cannot provide benefits for any year until a minimum deductible is satisfied. However, an HDHP may provide benefits for preventive care without imposing a deductible.
IRS Notice 2019-45 classifies certain medical care services and items, including prescription drugs, for chronic conditions as preventive care for individuals with those chronic conditions
This guidance makes it easier for HDHP participants to receive benefits for medications and other care to treat their chronic conditions. Employers with HDHPs should review their plan documents and consult with their carriers and benefit administrators, if necessary, to determine how their plans cover preventive care benefits.

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2019 Limits to Know

Many benefit plan limits have changed for the new calendar year. Here are those changes: 2019 Limits to Know Infographic:

  • 401K Limits:

    • Pre-Tax Contributions: $19,000 (up $500 from 2018)
    • Catch-Up Contributions: $6,000 (no change from 2018)

  • IRA Limits:

    • Contributions: $6,000 (up $500 from 2018)
    • Catch-Up Contributions: $1,000 (no change from 2018

  • Health Savings Account (HSA) Limits:

    • Pre-Tax Contributions:
      • Single Coverage: $3,500 (up $50 from 2018)
      • Family Coverage: $7,000 (up $100 from 2018)
    • Catch-Up contributions: $1,000 (no charge from 2018)

  • High Deductible Health Plans (HDHP) Limits:

    • HDHP Minimum Deductible
      • Single Coverage: $1,350 (no change from 2018)
      • Family Coverage: $2,700 (no change from 2018)
    • HDHP Maximum Out of Pocket Costs:
      • Single Coverage: $6,750 (up $100 from 2018)
      • Family Coverage: $13,500 (up $200 from 2018)

  • Flexible Spending (FSA) Limits:

    • Contributions: $2,700 (up $50 from 2018)

For more information on these limits, please contact us at 775-828-7420 today!


Click Here to Download: ACA Remains in Place After Being Struck Down by Federal Court

On Dec. 14, 2018, a federal judge ruled in Texas v. United States that the entire Affordable Care Act (ACA) is invalid due to the elimination of the individual mandate penalty in 2019. The decision was not stayed, but the White House announced that the ACA will remain in place pending appeal.

This lawsuit was filed by 20 states as a result of the 2017 tax reform law that eliminates the individual mandate penalty. In 2012, the U.S. Supreme Court upheld the ACA on the basis that the individual mandate is a valid tax. With the penalty’s elimination, the court in this case ruled that the ACA is no longer valid under the U.S. Constitution.


This ruling is expected to be appealed and will likely be taken up by the Supreme Court. As a result, a final decision is not expected to be made until that time. The federal judge’s ruling left many questions as to the current state of the ACA; however, the White House announced that the ACA will remain in place pending appeal.


The ACA imposes an “individual mandate” beginning in 2014, which requires most individuals to obtain acceptable health insurance coverage for themselves and their family members or pay a penalty. In 2011, a number of lawsuits were filed challenging the constitutionality of this individual mandate provision.

In 2012, the U.S. Supreme Court upheld the constitutionality of the ACA in its entirety, ruling that Congress acted within its constitutional authority when enacting the individual mandate. The Court agreed that, while Congress could not use its power to regulate commerce between states to require individuals to buy health insurance, it could impose a tax penalty using its tax power for individuals who refuse to buy health insurance.

However, a 2017 tax reform bill, called the Tax Cuts and Jobs Act, reduced the ACA’s individual mandate penalty to zero, effective beginning in 2019. As a result, beginning in 2019, individuals will no longer be penalized for failing to obtain acceptable health insurance coverage.

Texas v. United States

Following the tax reform law’s enactment, 20 Republican-controlled states filed a lawsuit again challenging the ACA’s constitutionality. The plaintiffs, first, argued that the individual mandate can no longer be considered a valid tax, since there will no longer be any revenue generated by the provision.

In addition, in its 2012 ruling, the Supreme Court indicated (and both parties agreed) that the individual mandate is an essential element of the ACA, and that the remainder of the law could not stand without it. As a result, the plaintiffs argued that the elimination of the individual mandate penalty rendered the remainder of the ACA unconstitutional.

The U.S. Justice Department chose not to fully defend the ACA in court and, instead, 16 Democratic-controlled states intervened to defend the law.

Federal Court Ruling

In his ruling, Judge Reed O’Connor ultimately agreed with the plaintiffs, determining that the individual mandate can no longer be considered a valid exercise of Congressional tax power. According to the court, “[u]nder the law as it now stands, the individual mandate no longer ‘triggers a tax’ beginning in 2019.” As a result, the court ruled that “the individual mandate, unmoored from a tax, is unconstitutional.”

Because the court determined that the individual mandate is no longer a valid tax, but is an essential element of the ACA, it ultimately ruled that the ACA is invalid in its entirety.

Because the court determined that the individual mandate is no longer valid, it now had to determine whether the provision is “severable” from the remainder of the law (meaning whether other portions of the ACA can remain in place or whether the entire law is invalid without the individual mandate).

In determining whether the remainder of the law could stand without the individual mandate, the court pointed out that “Congress stated three separate times that the individual mandate is essential to the ACA … [and that] the absence of the individual mandate would ‘undercut’ its ‘regulation of the health insurance market.’ Thirteen different times, Congress explained how the individual mandate stood as the keystone of the ACA … [and,] ‘together with the other provisions’ [the individual mandate] allowed the ACA to function as Congress intended.” As a result, the court determined that the individual mandate could not be severed, making the ACA invalid in its entirety.

Impact of the Federal Court Ruling

Judge O’Conner’s ruling left many questions as to the current state of the ACA, because it did not order for anything to be done or stay the ruling pending appeal. However, this ruling is expected to be appealed, and the White House announced that the ACA will remain in place until a final decision is made. Many industry experts anticipate that the Supreme Court will likely take up the case, which means that a final decision will not be made until that time.

While these appeals are pending, all existing ACA provisions will continue to be applicable and enforced. Although the individual mandate penalty will be reduced to zero beginning in 2019, employers and individuals must continue to comply with all other applicable ACA requirements. This ruling does not impact the 2019 Exchange enrollment, the ACA’s employer shared responsibility (pay or play) penalties and related reporting requirements, or any other applicable ACA requirement.

Please email or call us at 775-828-7420 if you have any questions about the above content.

HSA 101

HSA/HDHPs take a different approach to health coverage than other plans with lower deductibles. Having an HSA provides you with many benefits, including flexibility and easy saving, helping you plan and pay for medical expenses.

Click here for the Interactive HSA Guide to include:

  • HSA Eligibility
  • HSA Contributions
  • Using your HSA
  • HSA Saving and Recording
  • HSA Expense Log

Please feel free to call us at 775-828-7420 or email us if you have any questions about HSA’s.




Which Federal Employment Laws Apply to My Company?

 Provided by Clark & Associates of Nevada, Inc.

This is a good question and can be complicated! There are a number of different federal employment laws that have their own rules for covered employers. Employers should be aware of the federal employment laws that may apply to their company.

An employer’s size, or number of employees, is a key factor in determining which federal employment laws the employer must comply with. Some federal laws, such as the Equal Pay Act, apply to all employers, regardless of size. However, other laws, such as the Family and Medical Leave Act, only apply to employers that reach a certain employee count. Also, some federal laws, such as COBRA, include exclusions for certain types of employers (for example, churches).
This Compliance Overview provides a high-level overview of key federal employment laws and explains which employers they apply to. Most states also have their own labor and employment laws. This summary does not address state labor laws, and it also does not address additional compliance requirements for companies that contract with the federal government or businesses in specific industries.

Links and Resources

  • DOL’s “FirstStep Employment Law Advisor,” which helps companies determine which labor laws apply to their business
  • DOL’s webpage, which includes links to each state’s labor office
  • EEOC’s compliance resources for employers and small businesses



    • Equal Pay Act
    • Fair Labor Standards Act
    • Occupational Safety and Health Act
    • Immigration Reform and Control Act
    • Employee Retirement Income Security Act (ERISA)


    • Family and Medical Leave Act
    • Fair employment laws, such as the Americans with Disabilities Act and the Title VII of the Civil Rights Act
    • Consolidated Omnibus Budget Reconciliation Act (COBRA)
    • EEO-1 reporting
Law Brief Description Covered Employers
Age Discrimination in Employment Act (ADEA) Prohibits employers from discriminating against employees or applicants who are age 40 or older based on their age. Private-sector employers with 20 or more employees and state and local governments
Americans with Disabilities Act (ADA) Prohibits employers from discriminating against qualified individuals with disabilities in all employment practices, such as recruitment, compensation, hiring and firing, job assignments, training, leave and benefits. All employers with 15 or more employees
Consolidated Omnibus Budget Reconciliation Act (COBRA) Requires employer-sponsored group health plans to offer continuation coverage to eligible employees and their dependents when coverage would otherwise be lost due to certain events (for example, a termination of employment). Private-sector employers with 20 or more employees that sponsor group health plans. Most group health plans sponsored by state and local governments are also covered.

Group health plans sponsored by churches are exempt.

Consumer Credit Protection Act (CCPA) Protects employees from discharge because their wages have been garnished for any one debt and limits the amount of an employee’s earnings that may be garnished in any one week. All employers, regardless of size
Employee Polygraph Protection Act (EPPA) Prohibits employers from using lie detector tests, either for pre-employment screening or during the course of employment, with certain exceptions. All employers, regardless of size

Does NOT apply to federal, state and local governments

Employee Retirement Income Security Act (ERISA) Sets minimum standards for employee benefit plans, including retirement plans, such as 401(k) plans, and welfare benefit plans, such as group health plans. All private-sector employers, regardless of size, that maintain employee benefit plans. Government and church employers are exempt.
EEO-1 Report The Employer Information Report EEO-1 (commonly known as the EEO-1 Report) requires employers to submit employment data categorized by race/ethnicity, gender and job category to the EEOC. Private-sector employers with 100 or more employees.

State and local governments, primary and secondary school systems, institutions of higher learning and tax-exempt private membership clubs other than labor organizations are exempt from this reporting requirement.

Equal Pay Act (EPA) Employers must provide equal compensation to men and women who perform equal work within the same workplace. Virtually all employers are covered, regardless of size.
Fair Labor Standards Act (FLSA) Establishes minimum wage, overtime, recordkeeping and child labor standards for employers. Virtually all employers are covered, regardless of size.
Family and Medical Leave Act (FMLA) Requires employers to provide eligible employees with unpaid, job-protected leave for specified family and medical reasons. Private-sector employers with 50 or more employees, public agencies (for example, state and local governments), the federal government and local educational agencies
 Genetic Information Nondiscrimination Act (GINA) Prohibits employers from discriminating against employees or applicants based on their genetic information. All employers with 15 or more employees
Immigration Reform and Control Act (IRCA) Employers are prohibited from hiring and retaining employees who are not authorized to work in the United States. Employers and employees must complete the Form I-9 (Employment Eligibility Verification Form). All employers, regardless of size
Occupational Safety and Health Act (OSH Act) Requires employers to provide a safe workplace for their employees. Coverage is provided through either the federal Occupational Health and Safety Administration (OSHA) or by an OSHA-approved state job safety and health plan. Virtually all private-sector employers, regardless of size

Workers at state and local government agencies are NOT covered by federal OSHA but are protected under the OSH Act if they work in states that have OSHA-approved state programs.

Pregnancy Discrimination Act (PDA) Prohibits workplace discrimination based on pregnancy, childbirth or related medical conditions. All employers with 15 or more employees
Title VII of the Civil Rights Act Prohibits employers from discriminating in the workplace based on race, color, religion, sex or national origin. All employers with 15 or more employees
Uniformed Services Employment and Reemployment Rights Act (USERRA) Prohibits employers from discriminating against individuals on the basis of membership in the uniformed services with regard to any aspect of employment.


All employers, regardless of size
Worker Adjustment and Retraining Notification (WARN) Act Employers are required to provide a 60-day advance notice to employees of imminent covered plant closings and covered mass layoffs. Private-sector employers with 100 or more employees. Regular federal, state and local government entities that provide public services are NOT covered.

As always, please feel free to call our office at 775-828-7420 or contact us if you have any questions about the above content.





Addressing Opioids in the Workplace

There are over 42,000 opioid-related deaths in the United States each year, according to the Centers for Disease Control and Prevention (CDC)—a figure that has been rising steadily since the turn of the century. The opioid death rate is now more than five times greater than it was in 1999.

In addition to the skyrocketing opioid-related deaths, there are countless Americans who are still abusing prescription medications. This means employers must figure out how best to address this crisis with employees. That is where Clark & Associates can help.

The purpose of this toolkit is to help employers understand and deal with the opioid epidemic, create a healthier and more productive workforce, and reduce costs. This toolkit is not intended to replace the advice of a medical or legal professional. In many cases, you may need to contact a professional for assistance. However, this information can serve as a starting point for developing a meaningful opioid strategy.

We have published a helpful toolkit to help you address this problem.

Click Here to Download the Workbook: Benefits Toolkit – Addressing Opioids in the Workplace

Contact Us if you have any questions or need assistance putting a policy in place for this growing problem.

Business Travel Accident Insurance

Travel Insurance for Businesses  

Travel insurance offers a broad range of benefits and services, such as worldwide emergency hotline services, medical evacuation, reimbursement for unexpected cancellation or delay, and more. Companies with employees who travel for business may want to consider supplemental coverage from a travel insurance policy.

Why Buy?

Travel insurance is designed for problems that arise suddenly during a trip. Basic coverage usually includes reimbursement for trip cancellation, interruption and delay because of illness, bad weather, baggage loss or delay, medical insurance and medical evacuation (in case of illness or injury during travel), and a 24-hour assistance telephone line. Typical coverage costs 4 to 8 percent of the cost of the trip, depending on the trip’s length, the destination, the traveler’s age and the type of coverage. For example, insurance for a $2,000 trip may cost $80 to $160. If you consider the expense for any troubles your employees may encounter, travel insurance can be a cost-effective option to avoid that risk.

Insurance for International Business Travelers

Think about the following scenarios when traveling for business:

  • You receive notice that a top executive in your company was in a car accident while on a business trip in Milan.
  • You get a telephone call that an employee stationed for the month in Sydney experienced symptoms of a stroke.
  • There was an earthquake in Chile, which prevented an employee from returning on time from a business trip.
  • Several of your employees traveling together in Beijing came down with pneumonia.

These situations should prompt you to examine whether you would know what steps to take next. Do you know what guidance to give these employees? Could you direct them to any specific medical facilities? How familiar are you with the medical system of that country? How much would it cost to arrange alternate travel plans in the event of a delay or setback?

Purchasing an international travel insurance policy may be the only way you can cover all your bases. Employers can purchase insurance specific to employees they send overseas for business purposes—even if the trip is short term. Obtaining medical treatment and hospital care abroad can be expensive. Generally, American medical insurance is not accepted overseas, nor do the Social Security, Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States.

Instead employers can purchase supplemental medical coverage for their employees that their current health plan does not supply. For instance, medical travel insurance will pay for medical evacuation by helicopter if traveling in a place with inadequate facilities. This can otherwise cost up to $50,000. Employers with workers who travel internationally for business purposes should find out exactly what their health plans cover, in the event the employee needs medical treatment overseas.

Another form of travel insurance that an employer of overseas workers will want to consider purchasing is K&R insurance (Kidnap, Ransom and Extortion Insurance). In certain parts of the world, kidnapping and extortion of wealthy American executives has become a business. A basic K&R policy includes such things as hostage negotiations, ransom payment, loss of income, interest on bank loans and medical/psychiatric care. In most cases, the deductible requires the insured to pay about 10 percent of any loss. Policies carry about $20 million to $30 million limits, which is generally more than enough to pay a typical ransom. This insurance is particularly beneficial for those employees who travel to high-risk countries, which include Brazil, Colombia, Ecuador, India, Mexico, Nigeria, the Philippines and Venezuela.

Most insurance companies offer comprehensive policies for international employers in which K&R is only part of the package.  These policies can also cover areas such as foreign business auto rental, foreign commercial general liability, foreign voluntary workers’ compensation, foreign travel accident/sickness, marine ocean cargo, foreign commercial crime and political risk.

Additionally, the U.S. Government requires that employees hired by contractors and subcontractors to work on international government contracts be protected by Defense Base Act Coverage (DBA), regardless of their assignment or location. This coverage provides workers’ compensation benefits in the event of a work-related injury or illness. There are five employment situations which require this coverage:

  1. Any employee working on a military base or reservation outside the United States
  2. Any employee engaged in U.S. government-funded public works business outside the United States
  3. Any employee engaged in public works or military contract with a foreign government which has been deemed necessary to U.S. National Security
  4. Those employees who provide services funded by the U.S. government outside the realm of regular military issue or channels
  5. Any employees of sub-contractors of the prime or letting contractor involved in a contract like numbers 1-4 above

Purchase Considerations

Before buying travel insurance, consider the following:

  • Always comparison shop. Some plans include extras such as psychiatric treatment, a natural disaster benefit and even disposition of remains in the event of death.
  • Do not tell your employees if you purchased K&R insurance. This is to prevent employees from revealing this fact to potential kidnappers, making them a more lucrative target.
  • Be aware that some plans require your out-of-pocket payment, and then will pay claims after the traveler returns home.


For more information on travel insurance, including medical and K&R, go to the U.S. Department of State – Bureau of Consular Affairs Travel website at

If your employees travel on business, it is imperative that you provide them with Accident Insurance Protection.

Call us at 775-828-7420 to learn more about Business Travel Accident Insurance.



Fight Cancer with Food

A healthy lifestyle supports disease prevention, and adding the following body-strengthening foods into your diet can really go the extra mile.

Beans contain phytochemicals, which have been shown to prevent or slow genetic cell damage. Their high fiber content has been connected with a lower risk of digestive cancers.

Berries contain ellagic acid (most common in strawberries and raspberries) and anthocyansides (most common in blueberries). Ellagic acid helps prevent skin, bladder, lung and breast cancer by acting as an antioxidant and by slowing the reproduction of cancer cells.

Cruciferous vegetables such as broccoli, cauliflower, cabbage and kale are rich in a variety of compounds linked to slowing cancer growth and development, especially lung, stomach, colorectal, prostate and bladder cancer.

Dark, leafy green vegetables including romaine lettuce, mustard greens, chicory and Swiss chard contain carotenoids, a form of antioxidant that removes cancer-promoting free radicals from the body. These veggies are also rich in folate, which has been shown to reduce the risk of lung and breast cancer.

Flaxseed—eaten in the form of oil and meal—is believed to reduce the risk of breast, skin and lung cancer because of the presence of phytoestrogens.

Garlic, Onions, Scallions, Leeks and Chives contain compounds that are believed to slow tumor growth, especially in skin, colon and lung cancer.

Red grapes contain resveratrol, which is thought to prevent cell damage.

Green tea is rich in flavonoids, which slow or prevent the development of colon, liver, breast and prostate cancer cells.

Soy contains isoflavones that protect against bladder, cervix, lung and stomach cancer. Soy is also comprised of compounds that are similar to the body’s natural hormones, which may guard against breast and prostate cancer development.

Tomatoes are rich in Lycopene, which has been shown to fight prostate cancer, especially when consumed as tomato sauce, paste or juice. Lycopene may also protect against breast, lung, stomach and pancreatic cancer.

Whole grains contain fiber, antioxidants and phytoestrogen compounds, beneficial in decreasing the risk of developing most types of cancer.

Spices such as ginger and cumin are powerful cancer fighters.

Click Here to download the full article: Fight Cancer with Food

Set of berry on white close up

Broccoli and Cauliflower

Cluster of five tomatoes on a white background with basil.


Reasons to Get Health Insurance for Your Small Business Employees [Infographic]

As a business owner, you know how important it is to keep your employees happy, healthy, and productive. One way of doing that is to offer comprehensive health coverage. If you’re a small business owner in Nevada, you aren’t mandated to provide small business health insurance, but it may be worth your while to do so. Offering health insurance can help you attract and retain the best talent. Additionally, it can also help you save money on health care costs, since insurance providers can negotiate fees with hospitals, doctors, and other health care providers. Contrary to popular belief, small business health insurance in Nevada isn’t a waste of money. If your employees are happy and healthy, they are more productive. The more productive they are, the better for your bottom line.

Need more reasons to purchase health insurance for your small business employees? Check out this infographic. For more information or to get a quote, contact Clark & Associates today.

Nevada Small Business Health Insurance Infographic

Download “Small Business Health Insurance: Reasons to Buy Health Coverage for Your Employees” [Infographic]