What is the Upcoming Medicare GEP?

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If you’re new to Medicare, understanding the various enrollment periods can be a bit overwhelming. With the Annual Enrollment Period (AEP) coming to a close, two crucial enrollment periods are just around the corner: the General Enrollment Period (GEP) and the Medicare Advantage Open Enrollment Period (MAOEP).

Both run simultaneously from January 1st to March 31st.

First, some background. When you are new to Medicare, you have an Initial Enrollment Period (IEP) that runs for a total of 7 months: 3 months before the month you turn 65, the month you turn 65 and the 3 months following that month.

Example: If your birthday is December 3rd, your IEP starts on September 1st and ends on March 31st.

This is the best time to enroll in Original Medicare (Parts A and B together) because you’ll avoid potential penalty fees and delays in healthcare coverage.

However, if you happen to miss your Initial Enrollment Period (IEP), don’t worry. You get another chance each year during the General Enrollment Period (GEP) to sign up for Medicare Part A and/or Part B. During the GEP, you can only enroll in Medicare Part A and/or Part B.

During this time, you cannot:

  • Enroll in a prescription drug plan (Part D)
  • Buy a Medicare Advantage plan (Part C)
  • Change any existing coverage you might have (like going from one Advantage plan to another or dropping Part D)
  • Make any other changes to your coverage

Penalties for Signing Up Late

If you sign up for Parts A and/or B during the General Enrollment Period, you might have to pay extra on your usual premiums – that’s the penalty for signing up late. That’s why it’s a good idea to enroll during your Initial Enrollment Period (IEP).

  • Part A Late Enrollment:

If you need to purchase Part A and miss your first Medicare eligibility chance, your monthly premium may increase by 10%. The penalty lasts for twice the number of years you delayed. For example, if you wait 2 years to sign up, you’ll pay a higher premium for 4 years. Special Enrollment Periods may exempt you from penalties – check your eligibility.

  • Part B Late Enrollment:

You usually won’t face a Part B penalty with a Special Enrollment Period. Expect an extra 10% for each year you could have enrolled but didn’t. Your income may also affect your premium. Learn more about Special Enrollment Periods for your options here: Special Enrollment Periods | Medicare

During the GEP, there is another period called the Medicare Advantage Open Enrollment Period (MAOEP). The main difference between Medicare Advantage Open Enrollment and General Open Enrollment is who can use each one and what changes you can make.

The Medicare Advantage Open Enrollment Period (MAOEP) lets you:

  1. Change Medicare Advantage Plans: You must be already enrolled into a Medicare Advantage plan. If both Medicare Advantage plans are offered in your area, you may change from one to another.
  2. Go Back to Original Medicare: You can drop your Medicare Advantage plan and return to Original Medicare (Parts A and B), with a Part D prescription drug plan. You also have the option to add a Medicare Supplement (Medigap) policy. However, this is not a guaranteed issue. You will most likely have to go through Medical Underwriting.

During this time, You cannot:

  • Enroll in Medicare Advantage for the first time if you are currently on Part A and Part B (Original Medicare).

Understanding and navigating these enrollment periods is crucial for ensuring that you have the right Medicare coverage. If you have any questions or need more information on changing your plan, feel free to reach out to our office today at  (631) 476-4015 and we would be happy to assist you.

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November is Diabetes Awareness Month

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November is a crucial month in the health calendar as it is recognized as Diabetes Awareness Month. This is a time to bring attention to the disease and the millions of people affected by it. It’s also an excellent opportunity for us to shine a light on the importance of health, reminding everyone that your health matters!

  1. Type 1 Diabetes: An autoimmune condition where the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes need lifelong insulin therapy.
  2. Type 2 Diabetes: The most common form, often linked to lifestyle factors like poor diet and lack of exercise. It results in the body not using insulin properly or not producing enough, leading to elevated blood sugar levels.
  3. Gestational Diabetes: A temporary form that occurs during pregnancy, usually resolved after childbirth, but it increases the risk of developing type 2 diabetes later in life.

Diabetes Management and Medicare: Know the Updates for 2024

One of the most significant challenges for those managing diabetes is the cost of the necessary supplies and medications. However, for Medicare recipients, there will be some important changes starting in 2024 that could make managing diabetes more affordable.

What’s Covered Under Medicare Part B:

  • Injectable insulin used with a traditional insulin pump
  • Insulin used with a disposable insulin pump
  • Diabetes screenings and exams
  • Diabetes self-management training (DSMT) – Medicare may cover up to 10 hours of this initial training – 1 hour of individual and 9 hours of group training. You may also qualify for up to 2 hours of follow-up training in each calendar year that falls after the year you got your initial training.
  • Therapeutic shoes & inserts covered each calendar year:
  • One pair of custom-molded shoes and inserts
  • One pair of extra-depth shoes

Medicare will also cover:

– 2 additional pairs of inserts each calendar year for custom-molded shoes

– 3 pairs of inserts each calendar year for extra-depth shoes

In 2024, Medicare Part B will be extending the $35 monthly co-pay for insulin provided through durable medical equipment (DME). This is a significant improvement that will help many people manage their diabetes more effectively. Furthermore, blood sugar testing supplies will also be available with a $35 monthly co-pay, making it easier to monitor and manage diabetes-related complications.

Medicare Part D Coverage

For those using injectable insulin not associated with a traditional insulin pump or insulin used with a disposable pump, Medicare Part D has got you covered. Additionally, Part D covers certain medical supplies required for insulin injections, including syringes, gauze, and alcohol swabs. Insulin that is inhaled is also covered under Part D.

Starting January 2024, Medicare Part D will extend its coverage to include diabetes-related expenses. Under this plan, individuals can benefit from a $35 monthly co-pay for diabetes medications, and this cost won’t be subject to the plan’s deductible. This expansion is a positive step in making diabetes management more accessible and affordable for Medicare beneficiaries.

Medigap Coverage

If you have Part B and Medigap covering your Part B coinsurance, your plan should cover the $35/month (or less) cost for each covered insulin.

Reversal and Prevention- Keep Diabetes in Check!

Type 2 diabetes, which constitutes about 90-95% of all diabetes cases, is often associated with lifestyle factors. According to the International Diabetes Federation, over 50% of type 2 diabetes is preventable.  It’s essential to address preventive measures and potential reversals for individuals with type 2 diabetes or those at risk. For those with type 2 diabetes or at risk, lifestyle changes play a crucial role.

The 3 pillars to battle Diabetes are Weight loss, adopting a balanced diet, increasing physical activity.

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Streamlining your Medicare Finances Through Automatic Payment programs

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Many Beneficiaries wonder, what the best way is to pay for Medicare. In this blog, we’ll break down the essential details in simple terms, so you can effortlessly manage your healthcare expenses, and avoid a potential loss in coverage.

For the majority, Medicare Part A doesn’t require a monthly premium. Nevertheless, if you’re subscribed to Medicare Part B and you’re already receiving benefits from Social Security or Railroad Retirement Board, your Medicare Part B premium is commonly subtracted from your monthly benefit payment.

However, if you have Medicare Part B but haven’t started receiving Social Security or Railroad Retirement Board benefits, you can expect to receive a monthly bill known as the “Notice of Medicare Premium Payment Due” (CMS-500). You’ll have to arrange for payment of this bill every month.

Let’s start with the basics

What’s a premium, deductible, coinsurance, or copayment?

Premium: A monthly amount you pay for coverage, whether you get services or not.

Deductible: An amount you have to pay for covered services and items each year before Medicare or your plan starts to pay.

Coinsurance: A percentage of the cost that you pay. In Part B, you generally pay 20% of the cost for each Medicare-covered service.

Example 
A Medicare-covered service costs $100. Medicare pays $80 and you pay $20. ($100 x 20% = $20.)

Copayment: A fixed amount you pay for a Medicare-covered service, like $30.

There are 4 ways to pay your Medicare premium bill:

  1. Pay online through your secure Medicare account (fastest way to pay)- use this free service to pay by credit card, debit card, or from your checking or savings account.
  2. Pay directly from your savings or checking account through your bank’s online bill payment service- Some banks charge a service fee.
  3. Sign up for Medicare Easy Pay– free service, we’ll automatically deduct your premium payments from your savings or checking account each month.
  4. Pay by check or money order through mail – this is not an automatic payment set up, therefore it is up to the Medicare beneficiary to remember to submit their monthly payments on time.

When are Medicare premiums due?

All Medicare bills are due on the 25th of the month. In most cases, your premium is due the same month that you get the bill. For your payment to be on time, we must get your payment by the due date on your bill. Submit your payment at least 5 business days before the due date, so we can get it on time.

For your payment to be on time, we must get your payment by the due date on your bill. Submit your payment at least 5 business days before the due date, so we can get it on time.

What if your Medicare premium payment is late?

If you miss a payment, or if we get your payment late, your next bill will also include a past due amount.

If you get a Medicare premium bill that says “Delinquent Bill” at the top, pay the total amount due, or you’ll lose your Medicare coverage

Automatic Deduction from Social Security for Medicare Part B Premiums- What you need to know!

If you’re receiving Social Security benefits, it’s important to understand how Medicare premiums work.

If you receive Social Security benefits, your Medicare Part B premiums are automatically deducted from your monthly Social Security check.

The standard monthly deduction for most beneficiaries in 2024 is $174.70, covering Medicare Part B.

Please be aware, you won’t receive a separate bill for Medicare premiums, but you’ll get a monthly statement that details the deduction from your Social Security check.

Below is the Income-Related Monthly Adjustment Amount  (IRMAA) for 2024.

 Enrolled in Medicare but NOT Claiming Social Security Benefits? Here’s how to sign up!

You can sign up for Medicare Easy Pay Medicare Easy Pay | Medicare, a FREE service allowing automatic withdrawals of your monthly premiums from your checking or savings account.

Medicare Part A Premiums

Most people don’t pay Medicare Part A premiums, but if you haven’t paid Medicare taxes for at least ten years through your job, you may need to pay these premiums.

The 2024 Medicare Part A premium varies based on the number of quarters you’ve worked and paid Medicare taxes.

Medicare Advantage Plans and Part D Prescription Drug Plans

Some Medicare Advantage plans, and standalone Medicare Part D drug plans may offer the option to have your premiums deducted from your Social Security check. However, this is not an automatic process and you’ll need to contact your plan administrator to set it up or request it during enrollment.

Key Takeaways:

  • If you receive Social Security benefits, your Medicare Part B premiums will be taken directly from your monthly Social Security payment.
  • There are 4 other ways to pay your Medicare Premium.
  • If you have a Medicare Advantage or Medicare Part D drug plan, you can inquire with your plan administrator about the possibility of deducting your premiums from your Social Security benefit.
  • For those enrolled in Medicare but not receiving Social Security benefits, you can arrange for your monthly premiums to be automatically withdrawn from your checking or savings account by reaching out to Medicare.

In the world of Medicare, staying on top of your premiums is more than just a chore—it’s a vital step in ensuring seamless healthcare coverage. Failure to make timely payments can lead to the dreaded consequences of delinquent accounts and even the loss of coverage.

If you would like to learn more about how to set up your automatic payments to pay for your Medicare Premiums, you may contact us today.  

Resources:

www.medicare.gov

www.CMS.gov

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Breast Cancer Awareness Month: Helping Beneficiaries Navigate Their Medicare Coverage and Prevention

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October is Breast Cancer Awareness Month, a time dedicated to spreading knowledge about the most common type of cancer found in women. As your Senior Markets Specialist, it is our role to make sure you, as the Medicare beneficiary, are kept informed with Medicare coverage benefits, and encouraged to be proactive when it comes to your health. Here’s what you need to know about breast cancer awareness and the preventive screenings covered by Medicare.

Breast Cancer and Age

Women over 60 make up nearly half of new breast cancer cases, and an additional 20% of cases affect women over 70. That’s why it’s essential for Medicare beneficiaries to be aware of the risks and the importance of early detection.

Medicare Coverage for Preventative Screenings

Medicare now covers specific preventative screenings, such as mammograms, which can detect breast cancer before any signs or symptoms appear. Detecting breast cancer at an early stage significantly improves treatment outcomes.

Mammograms are covered once every 12 months for women aged 40 and older. Medicare also covers one baseline mammogram for women between 35-39.

If medically necessary, Medicare Part B covers diagnostic mammograms more than once a year. You’ll be responsible for 20% of the Medicare-approved cost after meeting any Part B deductibles.

Warning Signs

In addition to regular screenings, it’s crucial to be aware of potential warning signs. These symptoms could indicate a problem and should be discussed with your healthcare provider:

  • Lump on the breast: This is the most common symptom, and it’s important to note that 20% of lumps are cancerous.
  • Breast discharge of any kind.
  • Swelling and soreness in the underarm or breast.
  • Nipple inversion or skin dimpling.
  • Skin changes: Look out for redness, peeling, flaking, or crusting, either in a specific area or across the entire breast.

Breast Cancer Awareness: A Unified Effort

Breast Cancer Awareness Month is a time for all of us to come together, educate ourselves, and support those impacted by breast cancer. Medicare plays a vital role in ensuring individuals have access to the healthcare services they need during their breast cancer journey.

By staying informed, advocating for your health, and spreading awareness, we can work together to reduce the impact of breast cancer and empower individuals to live healthy, fulfilling lives. Remember, early detection is key, and Medicare is here to support you in your healthcare journey. Stay proactive, stay informed, and stay healthy.

If you’d like to learn more about your Medicare coverage and preventative services that may be included in your benefits, please contact us today at (631) 476-4015 and we would be happy to schedule a plan review.

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Navigating Alzheimer’s with Medicare

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September is World Alzheimer’s Month, so we feel it’s vital to equip ourselves, our clients, and community with knowledge about this condition and how Medicare can lend a helping hand.

Whether you’re directly impacted or simply curious, we’re here to provide you with clear, concise information to navigate this journey together.

Understanding Alzheimer’s:

 Alzheimer’s is a progressive brain disorder that affects memory and thinking. It’s common among seniors and can be challenging. But fear not – knowledge is power, and we are here to shed light on what to look for and how to seek help.

Spotting the signs Spotting the Signs:

  • Memory loss disrupting daily life
  • Challenges in planning or solving problems
  • Difficulty completing familiar tasks
  • Confusion with time or place
  • Trouble understanding visual images or spatial relationships
  • New problems with words when speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood and personality
  • Confusion with time or place
  • Trouble understanding visual images or spatial relationships
  • New problems with words when speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment

Understanding Your Medicare Coverage and preventative services:

Wondering how Medicare fits into the picture? We’ve got you covered. Discover what cognitive screenings and tests are covered by Part B, and how Part D can assist with certain medications related to cognitive symptoms.

Cognitive Impairment Screening: Medicare Part B provides coverage for cognitive impairment screenings for beneficiaries who exhibit symptoms of cognitive decline or are at risk for cognitive impairment. These screenings can help identify early signs of conditions like Alzheimer’s disease. Your healthcare provider can perform these assessments during your annual wellness visit or at other times when necessary.

Neurological Services: Medicare Part B covers a wide range of neurological services, including consultations and evaluations with neurologists or other specialists. These services are essential for diagnosing and managing conditions affecting brain health.

Alzheimer’s Medications: Medicare Part D, which is the prescription drug coverage portion of Medicare, covers medications used to treat Alzheimer’s disease. Common Alzheimer’s medications, such as cholinesterase inhibitors (e.g., donepezil) and N-methyl-D-aspartate (NMDA) receptor antagonists (e.g., memantine), are often included in Part D formularies. Beneficiaries with Alzheimer’s can enroll in a Part D plan to help cover the costs of these medications.

It’s important to note that specific coverage details can vary depending on your Medicare plan, including whether you have Original Medicare (Part A and Part B) with a separate Part D prescription drug plan or if you have a Medicare Advantage plan (Part C) that may bundle medical and prescription drug coverage. Therefore, it’s crucial to review your plan’s benefits, formulary, and any prior authorization requirements with your Medicare provider or plan administrator to understand the extent of coverage for Alzheimer’s-related services and medications.

Living Well and Planning Ahead:

Living with Alzheimer’s requires adapting to new routines and adjusting. Learn how staying mentally and socially active, maintaining a healthy diet, and engaging in regular exercise can contribute to your well-being. Also, get insights into planning for the future, including legal and financial aspects.

Support for Caregivers:

For caregivers, your role is invaluable. Learn about respite care options covered by Medicare and find out about support groups that can provide guidance and comfort.  Alzheimer’s can have a significant impact on mental health. Medicare covers mental health services, including counseling and therapy, which can be beneficial for individuals with Alzheimer’s and their caregivers.

Local Support Groups: Local Alzheimer’s support groups and community organizations often host informational sessions and provide resources for individuals and caregivers facing Alzheimer’s-related challenges. These groups can offer valuable connections and practical advice.

Join the Movement: World Alzheimer’s Month is a time to raise awareness and show our solidarity. Let’s share information, stories, and encouragement to create a network of understanding and compassion. Together, we can make a difference in the lives of those affected by Alzheimer’s. Stay tuned for more insightful posts throughout this special month. Remember, you’re not alone on this journey – together, we’ll navigate the path ahead.  Please contact us to learn more on preventative care services, and Alzheimer’s medications that may be covered under Medicare Part D.

Alzheimer’s Association: Website: www.alz.org This website is a wealth of information on Alzheimer’s disease, offering resources for patients, caregivers, and those interested in learning more. You can find information about symptoms, diagnosis, care options, and support services.

Medicare Official Website: Website: www.medicare.gov The official Medicare website provides comprehensive information about coverage and benefits for Medicare beneficiaries. You can learn about Medicare Part B coverage for cognitive assessments and screenings, as well as Part D coverage for certain medications related to cognitive symptoms. These resources can offer you detailed information and guidance to help you better understand Alzheimer’s disease and how Medicare can support you or your loved ones.

You can also download this helpful guide for more information.

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Hawaii’s Minimum Wage Rate Will Increase to $12 on Oct. 1, 2022

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On June 23, 2022, Hawaii adopted House Bill (HB) 2510. Among other things, HB 2510 raises the state’s minimum wage to $18 per hour by Jan. 1, 2028. The first increase will take place Oct. 1, 2022.

Hawaii Minimum Wage Rate

The table below provides an overview of Hawaii’s minimum wage laws.

Effective dateJan. 1, 2018Oct. 1, 2022Jan. 1, 2024Jan. 1, 2026Jan. 1, 2028
State of Hawaii$10.10$12$14$16$18
  • Tipped Employees: The maximum allowed tip credit toward the minimum wage is 75 cents per hour. If a tipped employee customarily and regularly receives more than $20 a month in tips, an employer may be able to pay tipped employees less than the applicable minimum wage by applying the tip credit. Click here for more information and illustrative examples of the calculation of the tip credit.
  • Domestic Workers: Minimum wage and overtime protections under Chapter 387 of the Wage and Hour Law generally apply to certain domestic workers. The law makes certain exceptions, including individuals employed in domestic services on a “casual basis” and individuals providing companionship services for the aged or infirm. Click here to read the text of the law.
  • Workers with Disabilities: On June 16, 2021, Hawaii repealed the ability of employers in the state to pay lower wage rates to employees with disabilities. As a result, employers in Hawaii are now required to pay their disabled employees a wage rate at or above the minimum wage rate.

Under a law in Hawaii, a hotel that applies a service charge for porterage services must distribute the service charge directly to its employees as tip income or clearly disclose to the purchaser of the services that the service charge is being used to pay for costs or expenses other than wages and tips of employees. “Porterage” means the act of moving luggage, bags, or parcels between a guest room and a lobby, front desk, or any area with vehicular access at a hotel, hotel-condominium, or condominium-hotel.

More Information

Please Note: The state laws summaries featured on this site are for general informational purposes only. In addition to state law, certain municipalities may enact legislation that imposes different requirements. State and local laws change frequently and, as such, we cannot guarantee the accuracy or completeness of the information featured in the State Laws section. For more detailed information regarding state or local laws, please contact your state labor department or the appropriate local government agency. 

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Rhode Island Repeals Subminimum Wages for Employees With Disabilities

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On June 15, 2022, Rhode Island adopted House Bill (HB) 7511 and HB 2242. This legislation effectively repeals the state provision that allowed employers to pay subminimum wages to employees with disabilities. HB 7511 and HB 2242 became effective on the day they were adopted.

Rhode Island Minimum Wage Rates

The table below provides an overview of minimum wage requirements in Rhode Island. 

Effective dateOct. 1, 2020Jan. 1, 2022Jan. 1, 2023Jan. 1, 2024Jan. 1, 2025
State of Rhode Island$11.50$12.25$13$14$15
  • Students: Full-time students under 19 years of age working in nonprofit religious, educational, librarial or community service organizations may receive a minimum wage rate equal to 90% of the minimum wage rate.
  • Youth Wage: 14- and 15-year-olds who do not work more than 24 hours per week may receive a wage rate equal to 75% of the applicable minimum wage rate. Youth employees who work more than 24 hours per week must receive the minimum wage rate. 
  • Tipped Employees: As of Jan. 1, 2017, state law allows employers to pay their tipped employees a minimum wage rate that is $3.89 lower than the state’s minimum wage rate. The $3.89 credit applies to restaurants, hotels and other industries where tipped employees usually work (except taxicabs and limited public motor vehicles). However, if an employee’s tips and the cash wage do not equal the minimum wage, the employer must make up the difference.
  • Employees With Disabilities: Beginning June 15, 2022, Rhode Island employers will no longer be allowed to pay wages below the state minimum wage rate to individuals “whose earning capacity is impaired by physical or mental disability,” even when this practice is still allowed under the federal Fair Labor Standards Act (FLSA). 

For more information contact the Rhode Island Department of Labor and Training.

Please Note: The state laws summaries featured on this site are for general informational purposes only. In addition to state law, certain municipalities may enact legislation that imposes different requirements. State and local laws change frequently and, as such, we cannot guarantee the accuracy or completeness of the information featured in the State Laws section. For more detailed information regarding state or local laws, please contact your state labor department or the appropriate local government agency. 

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DHS Ends Temporary COVID-19 Policy for Form I-9 Expired Documents

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On May 1, 2022, the U.S. Department of Homeland Security (DHS) ended the COVID-19 Temporary Policy for List B Identity Documents. As a result, employers are no longer allowed to accept expired List B documents when individuals fill out their Form I-9. In addition, if an employee presented an expired List B document between May 1, 2020, and April 30, 2022, employers are required to update their Form I-9 by July 31, 2022.

Remote Work

Tracking Hours of Work for Remote Workers

On Aug. 24, 2020, the U.S. Department of Labor (DOL) issued Field Assistance Bulletin No. 2020-5 to remind employers of their obligation to accurately account for the number of hours their employees work away from the employer’s facilities. While the bulletin was issued in response to the high number of employees working remotely because of the COVID-19 pandemic, the DOL is also reminding employers that the underlying principles apply to other telework or remote work arrangements. 

The Fair Labor Standards Act (FLSA) generally requires employers to compensate their employees for all hours worked, including overtime hours. As the Department’s interpretive rules explain, “work not requested but suffered or permitted is work time” that must be compensated.

This principle applies equally to work performed away from the employer’s worksite or premises, such as telework performed at the employee’s home. If the employer knows or has reason to believe that the work is being performed, he must count the time as hours worked.

Control Over Hours Worked

The FLSA requires an employer to “exercise its control and see that the work is not performed if it does not want it to be performed” (29 C.F.R. § 785.13). The employer bears the burden of preventing work when it is not desired, and “[t]he mere promulgation of a rule against such work is not enough. Management has the power to enforce the rule and must make every effort to do so.”

One way an employer may exercise such diligence is by providing a reasonable reporting procedure for nonscheduled time and then compensating employees for all reported hours of work, even hours not requested by the employer. 

If an employee fails to report unscheduled hours worked through such a procedure, the employer is not required to undergo impractical efforts to investigate further to uncover unreported hours of work and provide compensation for those hours. However, an employer’s time reporting process will not constitute reasonable diligence where the employer either prevents or discourages an employee from accurately reporting the time he or she has worked, and an employee may not waive his or her rights to compensation under the Act. 

Work that an employer did not request but nonetheless “suffered or permitted” is therefore compensable. “Employers must, as a result, pay for all work they know about, even if they did not ask for the work, even if they did not want the work done, and even if they had a rule against doing the work.” 

Constructive Knowledge

If the employer knows or has reason to believe that work is being performed, the time must be counted as hours worked. An employer may have actual or constructive knowledge of additional unscheduled hours worked by their employees, and courts consider whether the employer should have acquired knowledge of such hours worked through reasonable diligence

The FLSA’s standard for constructive knowledge in the overtime context is whether an employer has reason to believe work is being performed. An employer may have constructive knowledge of additional unscheduled hours worked by their employees if the employer should have acquired knowledge of such hours through reasonable diligence. 

Importantly, “[t]he reasonable diligence standard asks what the employer should have known, not what it could have known.” One way an employer generally may satisfy its obligation to exercise reasonable diligence to acquire knowledge regarding employees’ unscheduled hours of work is “by establishing a reasonable process for an employee to report uncompensated work time.” 

But the employer cannot implicitly or overtly discourage or impede accurate reporting, and the employer must compensate employees for all reported hours of work. Additionally, if an employer is otherwise notified of work performed through a reasonable method, or if employees are not properly instructed on using a reporting system, then an employer may be liable for those hours worked. 

Failure to Report Hours of Work

As mentioned before, if an employee fails to report unscheduled hours worked through such a procedure, the employer is generally not required to investigate further to uncover unreported hours. 

Though an employer may have access to non-payroll records of employees’ activities, such as records showing employees accessing their work-issued electronic devices outside of reported hours, reasonable diligence generally does not require the employer to undertake impractical efforts, such as sorting through this information, to determine whether its employees worked hours beyond what they reported. 

This is not to say that consultation of records outside of the employer’s timekeeping procedure may never be relevant. Depending on the circumstances, it could be practical for the employer to consult such records. If so, those records would form the basis of constructive knowledge of hours worked. 

“When the employee fails to follow reasonable time reporting procedures [he or] she prevents the employer from knowing its obligation to compensate the employee.” Moreover, where an employee does not make use of a reasonable reporting system to report unscheduled hours of work, the employer is thwarted from preventing the work to the extent it is unwanted, if the employer is not otherwise notified of the work and is not preventing employees from using the system. And the employer could not have “suffered or permitted” work it did not know and had no reason to believe was being performed. 

Accordingly, failure to compensate an employee for unreported hours that the employer did not know about, nor had reason to believe was being performed, does not violate the FLSA.

Verification of Employment Authorization Documents (Form I-9)

On March 19, 2020, the U.S. Department of Homeland Security (DHS) announced it will allow employers that are operating remotely to conduct a remote verification of approved Form I-9 documents. Because of ongoing COVID-19 concerns DHS has extended the Form I-9 requirement flexibilities to Oct. 31, 2022. 

Physical Inspection 

Employers must complete and sign Section 2 of Form I-9 within three business days of the employee’s first day of employment. Employers are required to physically examine the documents the employee presents from the list of acceptable documents to prove his or her employment eligibility.  

Remote Verification

The exemption also applies only to employers that are operating remotely due to COVID-19 and new hires affected by quarantine or lockdown protocols. The exemption does not apply to employers that have employees physically present at a work location.

Under the exemption, employers must complete a remote inspection of approved documents within three business days and enter “COVID-19” as the reason for the physical inspection delay. Employers that use this exemption must also keep written documentation of their remote onboarding and telework policy for each employee. 

Within three days of when normal operations resume, all employees who were onboarded using remote verification must present their approved documents for a physical inspection. When this happens, employers will need to add “documents physically examined” with the date of inspection to affected I-9 forms.

Expired List B Documents

On May 1, 2022, the U.S. Department of Homeland Security (DHS) ended the COVID-19 Temporary Policy for List B Identity Documents. As a result, employers are no longer allowed to accept expired List B documents when individuals fill out their Form I-9. In addition, if an employee presented an expired List B document between May 1, 2020, and April 30, 2022, employers are required to update their Form I-9 by July 31, 2022

Temporary Policy

DHS issued the temporary policy in response to the challenges many individuals experienced with renewing List B documents during the COVID-19 pandemic. 

Now that document-issuing agencies have reopened and provide alternatives to in-person renewals, the DHS has ended this flexibility. Employers will need to update Form I-9 for employees who used expired documents from List B. 

Required Form I-9 Updates

Employers must use the “Additional Information” field in the form’s Section 2 to enter the title, issuing authority, number and expiration date of the unexpired document. Employees may present a renewed List B document, a different List B document or a document from List A. Employers must also initial and date these changes. 

Employers should note that no action is required for individuals who used expired List B documents if: 

  • They are no longer employed; or
  • The List B document was auto-extended by the issuing authority (the document is considered unexpired when presented).

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New York COVID-19 Vaccination Leave Law Extended Through 2023

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New York state has extended its law requiring paid COVID-19 vaccination leave for employees through Dec. 31, 2023. The law had been scheduled to expire Dec. 31, 2022. It requires employers to provide a sufficient period of paid time to be vaccinated for COVID-19, up to four hours per vaccine injection. The law applies to all private employers and specified public employers. Workers may use leave under the state’s paid sick leave law for vaccine recovery.

New York Coronavirus Guidance

In response to the Coronavirus (COVID-19) global pandemic, state governments have issued guidance to help employers comply with labor and employment laws during the outbreak. Employer resources on the actions New York has taken during this time are provided below.

Because states are continually monitoring and responding to developments related to COVID-19, employers are strongly advised to visit the New York State Department of Health COVID-19 webpage for the latest updates and business-related resources. Local health department contact information can be found here.

Vaccination Mandate

Beginning in September 2021, the New York mandate at issue requires all health care workers in the state to be vaccinated against COVID-19. The only exception is for situations in which a worker presents written proof from a health care provider showing that the vaccine would be “detrimental” to the worker’s health “based on a pre-existing condition.”    

Supreme Court Case  

On Dec. 13, 2021, the U.S. Supreme Court issued an order denying a request from a group of health care workers to be exempt, on religious grounds, from New York’s statewide vaccination requirement for health care workers. The court previously rejected a similar challenge to Maine’s vaccine mandate for health care workers on Oct. 29, 2021.After two lower courts declined, the Supreme Court also refused to block the law. Because the case was brought on an emergency basis, the court did not explain its decision. 

However, a dissenting opinion notes that under guidance issued by the New York Department of Labor on Sept. 25, 2021, workers who lose their jobs because of their refusal to get vaccinated are automatically disqualified from receiving unemployment benefits in the state.

The upheld mandate applies to all hospitals, nursing homes, home care agencies and other health care facilities in New York. These employers should become familiar with the state vaccine mandate and the Supreme Court’s decision. In addition, all employers should become familiar with guidance on federal fair employment laws and workplace vaccination mandates issued by the federal Equal Employment Opportunity Commission (EEOC).

New York City Mandate

The mayor of New York City (NYC) has announced that, starting Dec. 27, 2021, nearly all employers in the city will be required to ensure their employees are vaccinated against COVID-19.  In-person workers will need to provide proof of two vaccine doses, except for those who have already received the Johnson & Johnson vaccine. The new vaccine mandate will apply to approximately 184,000 businesses.

While delivering the announcement on Dec. 6, 2021, NYC Mayor Bill DeBlasio indicated that workers will be able to ask for religious and medical exemptions. Acceptable proof of vaccination will include a vaccination card issued by the Centers for Disease Control and Prevention (CDC), the New York State Excelsior Pass, the Clear Health Pass, and the NYC COVID Safe App.

The mayor also indicated that NYC’s existing COVID-19 restrictions for entering certain public places, such as restaurants and theaters, will expand to require: 

  • At least one vaccine dose for children ages 5 to 11, starting on Dec. 14, 2021; and
  • Two vaccine doses for most adults and children aged 12 and older, starting on Dec. 27, 2021.

Supreme Court Rejects Religious Challenge to NYC’s Vaccine Mandate for Public Schools

On Feb. 11, 2022, the U.S. Supreme Court issued an order denying a request by a group of teachers and school administrators to be exempt, on religious grounds, from New York City’s (NYC) COVID-19 vaccination requirement for all in-person public school workers.  

The court previously rejected a similar request filed by the same group in September 2021. The court has also rejected similar challenges to New York’s statewide vaccine mandate for health care workers (Dec. 13, 2021) and Maine’s vaccine mandate for health care workers (Oct. 29, 2021). Because all of these cases were brought on an emergency basis, the court’s orders did not include an explanation. 

Background of NYC Vaccination Mandate 

Beginning Sept. 27, 2021, the NYC mandate at issue requires all in-person teachers and other public school workers to be vaccinated against COVID-19. While many similar orders and laws grant exceptions for medical reasons, religious reasons or both, the NYC mandate does not allow any exceptions.        

Supreme Court Case  

NYC public school employees sued the city to block it from enforcing the COVID-19 vaccine mandate against them due to their religious beliefs. After lower courts declined, the Supreme Court also refused to block the law. 

Employer Impact  

The upheld mandate only covers NYC employees and volunteers who work in school settings. Private employers should become familiar with guidance on federal fair employment laws issued by the federal Equal Employment Opportunity Commission, along with all applicable local, state and federal laws on vaccine mandates and religious exceptions.   

HERO Act

New York State’s Health and Essential Rights Act (NY HERO Act) was passed to prevent occupational exposure to airborne infectious diseases. The NY HERO Act covers all private employers in the state. The Act was signed into law on May 5, 2021, and was amended on June 11, 2021. The amendments, among other things, have extended the compliance deadline for key portions of the Act from June 4, 2021, to July 5, 2021. 

The NY HERO Act created Section 218-b of the New York Labor Law, which requires employers to establish an airborne infectious disease exposure prevention plan. Employers must post the plan in their workplace and meet other requirements for making their plans available to employees. 

The Commissioner of Health is required to create a model airborne infectious disease standard. Employers can adopt the model standard or establish an alternative plan that meets or exceeds its requirements. This section of the Act takes effect on July 5, 2021.  

The Act also created Section 27-d of the law, which permits employees to establish and administer joint labor-management workplace safety committees. This section of the Act takes effect on Nov. 1, 2021. 

Employee Leave

New York state enacted a law providing leave for employees subject to a quarantine or isolation order due to COVID-19, effective March 18, 2020. Whether and how much employee compensation is required during the leave depends on the size and net income of the employer, as follows: 

  • $1 million or less, and up to 10 employees: Unpaid leave through the end of the quarantine or isolation. (Employees are eligible for paid family leave and disability benefits.) 
  • More than $1 million, and up to 10 employees: Leave through the end of the quarantine or isolation, at least five days of which must be paid. (After five days, employees are eligible for paid family leave and disability benefits.) 
  • Between 11 and 99 employees: Leave through the end of the quarantine or isolation, five days of which must be paid. (After five days, employees are eligible for paid family leave and disability benefits.) 
  • 100 or more employees: 14 days of paid sick leave during quarantine or isolation. 
  • Public employers: 14 days of paid sick leave during quarantine or isolation.  

The law also allows paid family leave for employees to care for children under a quarantine or isolation order. Employees eligible for federal COVID-19-related leave may take state leave only to the extent that it exceeds the federal leave. Exceptions to the leave requirement apply for asymptomatic or undiagnosed employees who can work virtually, and for employees who traveled to affected regions (including states on New York’s travel advisory) for non-work purposes. 

According to guidance on the law from the New York Department of Labor, employees may not report to work and must be given paid leave for repeat periods of isolation or quarantine if:   

  • They test positive for COVID-19 after returning to work following isolation or quarantine; or
  • They continue to test positive for COVID-19 after isolation or quarantine ends. 

However, except for nursing home workers, it is not recommended that employees be tested to discontinue quarantine or isolation. Leave is limited to three periods of isolation or quarantine, and the second two periods must be based on a positive COVID-19 test. (On April 22, 2021, the New York Department of Health issued updated “Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure – Including Quarantine and Furlough Requirements for Different Healthcare Settings.”)

In addition, the guidance states that employees not under a quarantine or isolation order, whose employers nonetheless bar them from work due to COVID-19 exposure (or possible exposure), must be paid their regular rate until they return to work or enter quarantine or isolation. Notably, the COVID-19 leave law itself says leave is required only for employees who are under a quarantine or isolation order.

The state’s earlier FAQs on the law remain valid. For further information, contact the New York Department of Labor

New York has also passed a state law requiring that employees receive a sufficient period of paid leave to be vaccinated for COVID-19, up to four hours per vaccine injection, including booster shots. The law applies to all private employers and specified public employers. Employees must be paid their regular rate of pay during the leave, and the leave may not be counted against any other leave to which the employee is entitled, including paid sick leave required by state law. The law took effect March 12, 2021, and expires Dec. 31, 2023 (extended from an earlier expiration date of Dec. 31, 2022). The New York Department of Labor has issued FAQs on the law. 

Guidance from the New York Department of Labor states that workers may take leave under the state’s paid leave law to recover from COVID-19 vaccination side effects.

Unemployment

  • Waiver of 7-day waiting period requirement for accessing unemployment insurance benefits for people who are out of work due to Coronavirus (COVID-19) closures or quarantines. Click here for more information.

Guidance for Health Insurers

  • The State outlined a series of actions that New York health insurers are required or advised to take, including keeping New Yorkers informed regarding available benefits; offering, where possible, telehealth medical advice and treatment; and preparing insurers to cover the costs if a COVID-19 immunization should become available. 

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