January 2016, Center for Health Law Equity, LLC Newsletter
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Happy New Year!  

The Center for Health Law Equity, LLC, wishes you and yours a healthy and prosperous new year.

How Workers Compensation Cases can Help Reduce Occupational Stress 

For those of you charged with designing and implementing workplace wellness programs, you may wonder how you can make the business case for including individual and organizational approaches that will reduce occupational stress.  Health care providers as well as health promotion and human resource professionals know that physical fitness is only part of the answer in improving employee well-being.  So how can these professionals get more buy-in from corporate leadership to consider workplace culture as part of improving employee well-being?

The answer might be in workers compensation cases, at least in part.  Several recent cases from Mississippi, New York, Pennsylvania and Nebraska found that workers or their families were entitled to workers compensation benefits because of overburdening occupational stress.  In one case, Harper v. Banks, Finley, White & Co. of Mississippi, 167 So.3d 1155 (Sup. Ct. Miss. 2015), the workers compensation commission awarded Mr. Harper’s family benefits because Mr. Harper, who was the managing partner of an accounting firm, died from a stress-induced stroke.  Mr. Harper worked long hours and had a lot of responsibility.  Other than high blood pressure, he did not have any other symptoms of heart disease; just a very stressful job.  Another case involving Saks Fifth Avenue in New York awarded a sales associate workers compensation because his supervisors pressured him to fabricate sales, which was illegal and caused undue stress on the employee.  See Cox v. Saks Fifth Avenue, 130 A.D.3d 1236 (Sup. Ct. App. N.Y. 2015). 
A third recent case involved a registered nurse from Nebraska who was assaulted by a patient in the adolescent psychiatric unit.  She told her employer’s Employee Assistance Program (EAP) counselor that she did not feel safe working in that unit again.  Nevertheless, she continued to work in that unit and experienced two more assaults, which aggravated her major depressive disorder.  The workers compensation judge awarded her benefits.  Hynes v. Good Samaritan Hospital, 291 Neb. 757 (Sup. Ct. Neb. 2015).
A fourth recent case from Pennsylvania involved a 48-year-old field maintenance worker from Pennsylvania who suffered a fatal heart attack after working a 14-hour day that involved heavy labor.  The court awarded the employee’s wife workers compensation benefits after finding that the long, labor-intensive hours caused the employee’s heart attack.  The court noted that the employer did not alternate heavy workload days with lighter office duty days.  Dietz v. Workers’ Compensation Appeal Board, 2015 WL 7771080 (C.C. Pa. 2015).

Each of these cases teaches a key lesson for workplace wellness program designers:  job design and work environment play a crucial role in whether an employee experiences excessive stress.  As noted by the World Health Organization in its booklet Work Organization & Stress, workload and working hours, as well as participation and control, are stress-related hazards.  These workers compensation cases serve as a good reminder for workplace wellness program designers to keep work organization and culture in mind when designing and implementing wellness programs.

If you would like to learn more about how workers compensation and other laws may help you design more effective workplace wellness programs, please contact the Center for Health Law Equity, LLC.

IRS Issues Final Regulations Regarding How to Factor Wellness Incentives When Calculating Health Plan Affordability 

On December 18, 2015, the IRS published in the Federal Register final regulations regarding health plan minimum value and affordability for purposes of determining whether an employee is eligible for a premium tax credit in the Health Insurance Marketplaces.  Under the final rule, the IRS states that when determining whether an employer’s health plan is affordable to the employee for purposes of determining whether the employee can qualify for a tax credit on the “Exchange” or “Marketplace” (and therefore whether the employer may be subject to a penalty for failing to offer affordable coverage), the employer can factor in wellness incentives.  For wellness incentives unrelated to tobacco use, the employer must treat those incentives as unearned.  That is, the employer must assume that the employee will not earn the wellness incentives for participating in wellness programs that do not relate to tobacco use.  For wellness incentives related to tobacco use, the employer can treat those incentives as earned.  In other words, the employer can assume that the employee will earn the tobacco incentive (even if he or she ultimately does not earn that incentive) when determining whether the employer’s health plan is affordable to the employee.
For more information about the final rule, click here

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Please follow the Center for Health Law Equity, LLC’s on LinkedIn, Google+ and Facebook and “Like” our page.  We try to post updates and articles of interest to health and wellness professionals and organizations on each of these social media sites.  We would love to have you as part of our social media family!
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Congratulations to the winner of the $50 Amazon Gift Card,  Kari L.  
CFHLE thanks all of you who shared your perspective through our recent survey.  Most of you responded that you would find an online workplace wellness compliance help desk option a valuable tool.  Stay tuned for more information about that topic in the months ahead.

IRS Extends Filing Deadline for Forms 1094 and 1095 Relating to the ACA Employer Mandate

On Dec. 28, the IRS extended the due dates for new health care information reporting forms in 2016.   Insurers, self-insuring employers, other coverage providers, and applicable large employers now have additional time to provide health coverage information for 2015 to individual taxpayers and the IRS.  Providers and certain employers must now furnish individuals with either Form 1095-B or 1095-C by March 31, 2016.  The due dates for issuers filing these forms and the associated Form 1094 with the IRS are May 31, 2016 for paper filers and June 30, 2016 for electronic filers.
Attorney Barbara Zabawa to speak about designing a legally compliant wellness program on January 21, 2016 for The Alliance.  If you are interested in attending, you can register here.
WELCOA publishes Attorney Barbara Zabawa’s White Paper on How to Legally Incentivize HRAs and Biometric Screens.  If you are a WELCOA member, you can download the white paper here.  If not, please contact Barbara Zabawa at for a copy.   

Any Other Questions?
If you have any questions or ideas that might be useful to share in this monthly newsletter, please forward those questions or ideas to us at  We want to make this newsletter a helpful resource.
Copyright © 2016 The Center for Health Law Equity, LLC, All rights reserved.

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