How Will the NFIP’s New Pricing Model Affect Your Flood Insurance Premiums?

Are you ready for Risk Rating 2.0? The National Flood Insurance Program (NFIP) is rolling out the first major update to its rating and pricing methodology in 50 years. This is a big deal because the NFIP provides about $1.3 trillion of flood insurance coverage to more than 5 million policyholders nationwide. Risk Rating 2.0 is expected to produce increasingly equitable premiums that better reflect a property’s unique flood risk. A laudable goal indeed, but how will the NFIP’s new flood insurance pricing model affect your premiums in the near future?

The Federal Emergency Management Agency, which manages the NFIP, acknowledges that while some premiums will go down, others will go up. Ultimately, it will depend on your property’s individual flood risk. However, according to FEMA, 96% of current policyholders will see either an immediate premium decrease or an increase of less than $20 per month under the new pricing model. FEMA is predicting the following changes to the NFIP’s average monthly premium under the new flood insurance pricing model.

Nationwide

  • 23%        Immediate decrease of $86 per month
  • 66%        $0 – $10 increase per month
  • 7%          $10 – $20 increase per month
  • 4%          $20+ per month

Florida

  • 20%        Immediate decrease
  • 68%        $0 – $10 increase per month
  • 8%          $10 – $20 increase per month
  • 4%          $20+ per month

It’s worth noting that all policyholders have been subject to NFIP premium increases every year. That’s because FEMA has a statutory obligation to charge actuarially sound flood insurance premiums. Under the current pricing model, policyholders on average see premium increases of $8 per month. However, according to FEMA, rate increases will not continue indefinitely under Risk Rating 2.0.

So, when will flood insurance premiums start to change? Due to the significance of the rating overhaul, FEMA is taking a phased approach to rolling out the new pricing model.

  • Phase I. Beginning October 1, 2021, new policies will be subject to Risk Rating 2.0 and existing policyholders can start taking advantage of immediate premium decreases upon policy renewal.
  • Phase II. Beginning April 1, 2022, all renewing policies will be subject to Risk Rating 2.0.

Risk Rating 2.0 will not change mandatory flood insurance requirements. Lenders will continue using Flood Insurance Rate Maps (FIRMs) to identify properties located within Special Flood Hazard Areas and determine whether flood insurance is mandatory under federal law. Those not required by law or by their lender to carry flood insurance should have it anyway. Flooding is the most common and costliest natural disaster in the United States. Flood insurance is important to everyone, everywhere because there’s no such thing as a No-Flood-Zone.

Please contact us to discuss how the NFIP’s Risk Rating 2.0 may affect your personal and commercial flood insurance premiums.

Largest Minimum Wage Increase in Florida History is Less than Six Months Away

When Florida enacted its own minimum wage in 2005, the minimum hourly wage went up $1. Despite going up every year since, this is still the largest single increase in Florida history…for now. On September 30, 2021, Florida’s minimum wage will go from $8.65 to $10, an increase of $1.35 per hour. In other words, Florida employers have less than six months to prepare for the largest minimum wage increase ever.

Depending on workforce make-up, the resulting increase in payroll expense may be minimal for some and substantial for others.

The upcoming increase is required by the $15 Minimum Wage Ballot Initiative (Amendment 2), which was approved by Florida voters in November 2020. Amendment 2 increases Florida’s minimum wage incrementally over a period of years until it reaches $15 per hour. The first (and largest) increase will occur September 30, 2021. It will then increase annually on September 30th per the following schedule.

  • 2021       $10.00
  • 2022        $11.00
  • 2023        $12.00
  • 2024        $13.00
  • 2025        $14.00
  • 2026        $15.00
  • 2027        Annual adjustments for inflation resume.

As of September 30, 2021, a minimum wage employee working full-time will need to be paid an additional $54 per week. Depending on the workforce make-up, the resulting increase in payroll expense may be minimal for some and substantial for others. Employers should start planning now to avoid unintentional, unnecessary and costly wage and hour violations. These plans should extend beyond this year’s record-breaking increase. There will be five more increases under Amendment 2, each of which is large enough to tie the current record for largest single increase in Florida history.

To reduce the likelihood of costly mistakes, employers should provide wage and hour training to managers and supervisors. Employers should also carry Employment Practices Liability Insurance with limited coverage for wage and hour claims. Contact us to learn more about protecting your business with Employment Practices Liability Insurance.

OSHA Launches Program to Protect High-Risk Workers from COVID-19

Did you know that OSHA is specifically targeting restaurants, supermarkets and other businesses for COVID-related inspections? The Occupational Safety and Health Administration recently launched a National Emphasis Program (NEP) to significantly reduce the number of workplace exposures to COVID-19. To accomplish this goal, OSHA will be focusing enforcement efforts on employers that put the largest number of workers at serious risk of contracting COVID-19 in the workplace.

Regional offices will conduct planned inspections to find COVID-related hazards in the workplace, but they aren’t being done randomly. OSHA is specifically targeting industries with the most workers expected to perform tasks associated with COVID-19 exposure and infection. OSHA is using North American Industry Classification System (NAICS) codes to generate a list of primary and secondary targets.

Primary targets include healthcare industries with the most COVID-related OSHA enforcement activities over the past year. It also includes NAICS codes for various non-healthcare industries, including:

  • 445110 Supermarkets and Other Grocery (except Convenience) Stores
  • 452112 Discount Department Stores
  • 493110 General Warehousing and Storage
  • 722511 Full-Service Restaurants
  • 722513 Limited-Service Restaurants

The list of secondary targets is made up of NAICS codes for non-healthcare essential workers who are likely to have the highest frequency of close contact with the public or coworkers. It includes industry codes used in the construction, food and agriculture, manufacturing and transportation sectors. The NEP also requires OSHA to focus enforcement efforts on employers that engage in retaliation against employees who complain about unsafe conditions or exercise other rights under the Occupational Safety and Health Act.

Employers must provide a work environment free from recognized hazards that are causing or are likely to cause death or serious physical harm, like COVID-19. Since the NEP specifically includes establishments with fewer than 10 workers, all businesses with NAICS codes appearing on OSHA’s list of primary and secondary targets may be hearing from OSHA soon.

Please contact us for more information about risk management measures and insurance to protect businesses and employees during the COVID-19 pandemic.

EEOC’s Enforcement and Litigation Capabilities Endure Despite COVID-19

The Equal Employment Opportunity Commission released its enforcement and litigation data for fiscal year 2020. COVID-19, it seems, did not impair the EEOC’s ability to enforce the nation’s equal employment opportunity laws. In 2020, the EEOC:

  • received 67,448 charges of workplace discrimination;
  • responded to more than 470,000 calls and more than 187,000 inquiries;
  • resolved 70,804 charges and 165 merit lawsuits;
  • secured $439.2 million for victims of discrimination;
  • recovered $106 million through litigation (the most in 16 years); and
  • was nearly perfect in court (95.8 percent success rate).

Retaliation remained the most frequently cited claim, accounting for more than half of all charges filed last year. Here is a breakdown of the charges received by the EEOC in 2020. Note that charges often allege more than one category of discrimination.

  • Retaliation: 37,632 (55.8 percent of all charges filed)
  • Disability: 24,324 (36.1 percent)
  • Race: 22,064 (32.7 percent)
  • Sex: 21,398 (31.7 percent)
  • Age: 14,183 (21.0 percent)
  • National Origin: 6,377 (9.5 percent)
  • Color: 3,562 (5.3 percent)
  • Religion: 2,404 (3.6 percent)
  • Equal Pay Act: 980 (1.5 percent)
  • Genetic Information: 440 (0.7 percent)

Employers must have a policy prohibiting discrimination and harassment in the workplace. Managers and employees must be trained to prevent and avoid unlawful behavior. Employers need Employment Practices Liability Insurance to cover the high cost of defending actual and alleged claims of unlawful conduct. Why? The EEOC is watching and offending employers are paying.

Please contact us if you would like to learn more about Employment Practices Liability Insurance.

Business Insurance 101: Certificates of Insurance

Certificates of Insurance make the business world go round and round. General contractors demand them from subcontractors. Commercial lenders request them from borrowers. Landlords require them from tenants. Virtually every business will request or will be asked to provide a Certificate of Insurance at one time or another, which raises an important question. What’s a Certificate of Insurance?

Certificates of Insurance (COIs) are used to verify insurance coverage. They are issued by insurance companies and agents to provide proof of insurance to the person or entity needing verification—the certificate holder. COIs provide specific information about existing insurance coverage, such as:

It’s important to know what COIs are, but so is knowing what they are not. Certificates of Insurance:

  • Are NOT insurance policies.
  • Do NOT provide certificate holders with any rights under the insured’s policy.
  • Do NOT extend or modify the coverage provided by the insured’s policies.
  • Do NOT create a contract between the insurance company and the certificate holder.

COIs are provided for informational purposes only. They offer a superficial snapshot of insurance coverage that is in place at the time it is created. Nothing more. In fact, a COI issued today may be out of date tomorrow. The only way to truly evaluate insurance coverage is by reading the policy itself. Nevertheless, as long as you understand their limitations, Certificates of Insurance provide a quick, easy and efficient way to request or provide proof of insurance coverage.

Please contact us to learn how Setnor Byer Insurance & Risk can help manage your Certificates of Insurance.

Can Employers Make the COVID-19 Vaccine Mandatory for Employees Under the Americans with Disabilities Act?

Setnor Byer Insurance & Risk

The COVID-19 vaccines provide a glimmer of hope as new cases surge nationwide. It also raises some interesting questions for employers. How, for example, will the vaccine’s increasing availability be viewed in the context of the Americans with Disabilities Act (ADA)? Can employees be required to provide proof of vaccination? Can employers make COVID-19 vaccines mandatory for employees? Fortunately, the Equal Employment Opportunity Commission issued updated guidance to help employers answer some COVID-19 vaccine-related questions that are likely to arise in the near future.

Is asking or requiring an employee to show proof of COVID-19 vaccination a disability-related inquiry under the ADA? According to the EEOC, no. Simply requesting proof of vaccination is not likely to elicit disability-related information, so it’s not a disability-related inquiry. However, the EEOC cautions that subsequent questions (Why didn’t you get vaccinated?) may elicit information about a disability and would need to be job-related and consistent with business necessity. The EEOC recommends warning employees not to provide any medical information as part of the proof in order to avoid implicating the ADA.

How should employers respond to employees who are unable to get vaccinated because of a disability? The ADA allows employers to protect against direct threats to workplace health or safety. However, if a COVID-19 vaccination requirement screens out or tends to screen out individuals with disabilities, the employer must show that an unvaccinated employee would pose a direct threat due to a significant risk of substantial harm that cannot be eliminated or reduced to an acceptable level by reasonable accommodation. Managers and supervisors responsible for communicating an employer’s COVID-19 vaccination requirement should know how to recognize and respond to accommodation requests. The EEOC urges employers and employees to engage in a flexible, interactive process to identify accommodations that do not constitute an undue hardship (significant difficulty or expense).

Though employers may rely on CDC recommendations when evaluating reasonable accommodations, the EEOC concedes that an accommodation may not be possible in some situations. If that’s the case, the employer may exclude the employee from physically entering the workplace, but the employee should not be automatically terminated. According to the EEOC, employers must first determine whether the employee is protected under any other provision of the ADA or other any other applicable federal, state or local law before taking any adverse action.

Determining if a direct threat exists and whether it can be eliminated or reduced with a reasonable accommodation generally requires an individualized assessment. Some situations may be black or white, but most will be different shades of gray. Employers may need to consult with counsel throughout the process to avoid unintentional, yet costly mistakes.

Please contact us for additional information about protecting your business during the COVID-19 pandemic.

OSHA Inspections and Penalties for Coronavirus-Related Violations on the Rise

Setnor Byer Insurance & Risk

Did you know that the Occupational Safety and Health Act’s health and safety standards apply to COVID-19? Since the coronavirus pandemic began, the Occupational Safety and Health Administration (OSHA) has received approximately 12,000 complaints and conducted nearly 300 inspections related to COVID-19. These inspections have resulted in proposed penalties against employers totaling more than $3.5 million.

The most common violations cited by OSHA include failures to:

While covered employers are responsible for complying with all applicable health and safety standards, those relating to personal protective equipment (PPE), respiratory protection and sanitation may be especially relevant for preventing the workplace spread of COVID-19. Employers that are not subject to a specific OSHA standard must still comply with the OSH Act’s General Duty Clause, which requires each employer to provide a workplace that is free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees.

OSHA’s emphasis on preventing the spread of COVID-19 in the workplace should provide more than enough motivation for employers to do the same. Employers wanting to protect their business and avoid severe OSHA penalties must do their part to protect workers from COVID-19, including the implementation of appropriate preventative measures as required by applicable law or recommended by relevant public health authorities, like the Centers for Disease Control and Prevention (CDC).

Please contact us for more information about protecting your business and your workers during the COVID-19 pandemic.

Affordable Care Act Update: IRS Extends ACA Reporting Deadline and Good-Faith Relief from Penalties

Setnor Byer Insurance & Risk

This seemingly endless year is almost over…finally. That means it’s time for Applicable Large Employers (ALEs) to start focusing on the Affordable Care Act’s annual information-reporting requirements. Fortunately, the Internal Revenue Service extended the deadline for ALEs to furnish 2020 information statements to employees. However, the deadline for ALEs to file information returns with the IRS has not been extended.

Applicable Large Employers, which are generally employers with 50 or more full-time or full-time equivalent employees in the previous year, must do the following to comply with the ACA’s annual reporting requirements.

Furnish Information Statements to Employees. The IRS extended the deadline to furnish 2020 Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) to employees from January 31, 2021 to March 2, 2021. This is the sixth consecutive year the IRS has extended this deadline.

File Information Returns and Transmittals with the IRS. Each 2020 Form 1095-C must also be filed with the IRS on or before February 28, 2021 (March 31, 2021, if filed electronically). The IRS did NOT extend this filing deadline. However, employers may request an automatic 30-day extension by filing Form 8809 before the ACA filing deadline.

The IRS also extended the good-faith relief from penalties that may be levied against ALEs for failing to comply with the ACA’s filing and furnishing requirements, which can be up to $280 per form. To be eligible for this relief, employers must make a good-faith effort to comply. In determining good faith, the IRS will consider whether reasonable efforts were made to prepare the required reports.

It’s important to note that this relief applies to forms with missing or inaccurate information. ALEs that fail to timely file or furnish the required reports are not eligible. According to the IRS, this is the last year they intend to provide good-faith relief from the ACA’s penalties.

Please contact us if you would like to learn more about ACA-compliant group health plans.

Understanding The COVID-19 Business Interruption Insurance Quandary

This article was originally published in the Summer 2020 issue of ActionLine, a Florida Bar Real Property, and Trust Law Section publication.

The coronavirus disease 2019 (COVID-19) pandemic appears to have softened the ground for a legal battle between commercial property insurance companies and the growing number of businesses seeking reimbursement for their lost revenues. Insurers are experiencing a surge in the reporting of COVID-19 business interruption claims and anticipate a significant uptick in litigation relative to this complex matter.

Most will essentially be asking the same question. Does business interruption or civil authority insurance cover the income lost by businesses while they were closed because of COVID-19? If the answer is yes, insurance companies may end up paying billions of dollars to cover a risk that was not specifically underwritten or offset by premiums. If the answer is no, countless businesses may find that the doors they closed during the COVID-19 pandemic will never be opened again.

Business interruption coverage, which is also known as business income coverage, is a type of commercial property insurance that covers the loss of income suffered by a business that is forced to slowdown or suspend its operations because the premises are damaged by a covered cause of loss. Business interruption policies often include a civil authority clause that covers the loss of income caused by action of civil authority that prohibits access to the insured premises because other property (i.e., not the insured premises) was damaged by a covered cause of loss.

Notably, the word virus is not typically found in standard commercial property policies. This means that COVID-19 claims are not specifically covered or excluded. If the policy’s conditions for business interruption or civil authority coverage are otherwise satisfied, claims cannot be denied merely because COVID-19 was the cause. On the other hand, if a policy does have a virus exclusion then a COVID-19 claim would not be considered a covered loss and there can be no business interruption or civil authority coverage. Insurers are expected to start adding virus-specific exclusions to new policies and upon the renewal of existing policies. 

In the absence of an express virus exclusion, the only way to know whether business interruption or civil authority coverage will apply to a COVID-19 claim is to examine the policy itself. The ISO Business Income (and Extra Expense) Coverage Form, which is a standard form used by admitted insurance companies, provides that the insurer “will pay for the actual loss of Business Income you sustain due to the necessary ‘suspension’ of your ‘operations’ during the ‘period of restoration.’” This provision appears to support the contention that business closures caused by COVID-19 are indeed covered, but it cannot be interpreted in isolation.

The construction and interpretation of an insurance policy is a question of law for the court to decide. Courts must analyze and interpret insurance policies as a whole, endeavoring to give every provision its full meaning and operative effect. Courts may not rewrite policies, add meaning that is not present or interpret policies in a manner that is contrary to the intention of the parties. Importantly, courts cannot focus on some provisions to the exclusion of the others. This interpretational limitation is crucial because the very next sentence in the policy states that the suspension of operations “must be caused by direct physical loss of or damage to” the insured property. The standard civil authority clause similarly requires “direct physical loss of or damage to” property other than the insured property. In other words, there can be no business interruption or civil authority coverage without direct physical loss of or damage to the insured property or other property.

Ultimately, many if not most of these lawsuits will come down to a seemingly simple question. What does direct physical loss of or damage to property mean? Courts must analyze and interpret the specific policies at issue according to their plain meaning. Since “direct physical loss of or damage to” is not defined in the standard ISO policy form, reference to legal or non-legal dictionaries may be necessary. Business interruption is not a new form of insurance coverage. Identical policy provisions have already been interpreted by multiple courts, albeit under different circumstances, though outcomes have varied. COVID-19 cases, however, will no doubt test the limits of existing case law.

There are other coverage requirements that may prove equally problematic for COVID-19 claimants. For example, coverage typically commences 72 hours after the time of direct physical loss or damage. It ends when the damage is repaired. This may disqualify many from coverage if it is determined that a thorough cleaning with basic disinfecting supplies is sufficient to remove COVID-19 from the premises. Policyholders may also find it difficult to prove that the suspension of business operations was necessary when other businesses facing similar circumstances remain open.

Finally, it is worth noting that legislative efforts may affect the trajectory of COVID-19 business interruption litigation. Whether these or similar bills ultimately become law remains to be seen, but the insurance industry will likely commit considerable resources to resist the enactment or enforcement of any such legislation.

These are unprecedented times. Insureds and insurers alike are facing existential threats through no fault of their own. Public policy concerns will no doubt influence the manner in which COVID-19 business interruption claims are resolved. Shutting down the economy was a drastic, yet necessary measure to stop the spread of COVID-19. But it comes with a cost. Courts will soon be called upon to decide who should pay.

Affordable Care Act: Will Your Group Health Plan be Affordable in 2021?

The Affordable Care Act’s affordability threshold for employer-sponsored group health plans will increase to 9.83 percent in 2021. The affordability threshold is currently 9.78 percent. The impending increase primarily affects employers with 50 or more full-time or full-time equivalent employees. The ACA generally requires these Applicable Large Employers (ALEs) to offer full-time employees “affordable” minimum essential health care coverage; otherwise, they may have to pay the ACA’s employer shared responsibility (pay-or-play) penalty.

Affordability is calculated as a percentage of household income. In 2021, the amount an employee must pay (required contribution) for the lowest-cost, self-only coverage option offered by their ALE cannot be more than 9.83 percent of the employee’s household income. If it is, the employee’s offer of health coverage is not considered affordable and the ALE may be assessed a penalty under the ACA.

ALEs can use one of the ACA’s affordability safe harbors to determine the most employees can be required to pay without exceeding the affordability threshold. For example, if Sam earned $12 per hour in 2021 and worked 40 hours per week for 52 weeks, Sam’s monthly required contribution for coverage under the ALE’s 2021 calendar year group health plan cannot exceed:

  • — $204.46 per month, if using the W-2 Safe Harbor Method;
  • — $153.35 per month, if using the Rate of Pay Safe Harbor Method; or
  • — $104.53 per month, if using the Federal Poverty Line Safe Harbor Method.

Even though the affordability threshold for group health plans beginning in 2021 is only .05 percent higher than the year before, the difference can be consequential. To ensure compliance with the ACA’s affordability requirement in 2021, ALEs need to evaluate and possibly adjust their health plan pricing options, cost-sharing structure, and in some cases, compensation levels.

Please contact us if you would like to learn more about ACA-compliant group health plan options for 2021.