tty: common law employer e-mail: informational packet · common law employer informational packet ....

New OLTL Employer Informational Packet Version 1.1

Dear Participant/Common Law Employer:

You have received this letter because you have been referred for participant directed services through the Pennsylvania Office of Long-Term Living (OLTL). In the OLTL program you have the opportunity to recruit and hire your own staff to assist you in remaining independent in your home and/or work place. Public Partnerships, LLC (PPL) is the Vendor Fiscal/Employer Agent (VF/EA) that will support you by paying direct care workers (DCWs) and qualified vendors and assuming responsibility for managing tax filings on your behalf.

Once you and your DCW review, sign, and complete all required paperwork, PPL will provide you with written notification that you have successfully completed all of the necessary requirements. PPL will provide payment only for services that your DCW(s) provide after receiving written notification. PPL is committed to providing you with as much support as possible; however, we must adhere to federal, state, and local tax laws. Therefore, all the common law employer (employer), DCW, and vendor paperwork must be signed and returned to PPL before payments are issued to your DCW(s) and/or vendors.

This packet contains information and instructions regarding the required and optional employer enrollment paperwork that you need to complete and return to PPL. Please review the informational forms and instructions to ensure that you understand the necessary roles and responsibilities and complete the forms accurately. If you require program materials in alternate print format or languages (for example, Braille or large print) please contact our customer service team.

Public Partnerships encourages you to call us at (877) 908-1750 if you have any questions regarding payroll requirements or the process in general. Our customer service team is available Monday through Friday 8:00am until 8:00pm EST and Saturday 9:00am to 1:00pm. PPL staff is available to help walk you through the forms over the phone. We look forward to working with you!

Sincerely,

Public Partnerships, LLC

PA OLTL Programs Public Partnerships, LLC PO Box 61257 Harrisburg, PA 17106-1257

Phone: 1-877-908-1750 TTY: 1-800-360-5899 Administrative Fax: 1-855-858-8158 E-mail: [email protected]

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What is my role as a common law employer? What is PPL’s role in the process?

The following are frequently asked questions by participant/employers in regards to PPL services.

Participant Directed Services allow you to use OLTL funds to hire your own DCWs. You are the common law employer and PPL is your Financial Management Service. Below is a brief summary of what is done by whom:

As an Employer, you will:

Recruit, hire, train, and fire all DCWs Submit signed timesheets to PPL noting hours worked for each DCW Establish wage rates and performance evaluation criteria for each DCW Establish schedules and tasks to be completed by each DCW

As your Agent, PPL will:

Perform a criminal background check on prospective DCWs Issue paychecks to DCWs bi-weekly with the receipt of properly submitted

timesheets Withhold appropriate taxes at the state and federal level for each DCW File monthly, quarterly, and annual forms and tax deposits with state and federal

agencies (See below to learn more about what taxes are withheld) Issue W-2 Statements to each DCW in January, and provide you with regular

payroll status reports through the year Arrange to purchase workers compensation insurance to cover your DCWs Provide reports to you on a monthly basis to assist you in managing your budget Answer all questions that you and your DCWs have about enrollment, timesheets,

and payments Help you and your DCWs with the enrollment process through our Customer

Service Center

What taxes are withheld for my each of my DCWs?

All DCWs must pay taxes. PPL will withhold Social Security, Medicare (FICA), and state and federal income taxes from each DCW’s paycheck. A summary of all DCW tax withholdings will appear on their paycheck stub. Furthermore, PPL will prepare and mail a W-2 Wage Statement to each DCW in January.

Do common law employers pay taxes too?

Yes. As a common law employer, you must match each DCW’s Social Security and Medicaid (FICA) contribution. In addition, as the employer, you must pay federal and state unemployment and workers compensation insurance premiums for each DCW. Acting as your agent, PPL will


complete all this paperwork, and send you regular reports on progress. These tax payments are made using your OLTL Program funds.

Will I be required to pay for services out of my own pocket?

No. All payroll related expenses are funded using OLTL Medicaid funds. These expenses include DCW wages and taxes, and employer payroll taxes, unemployment insurance, and workers compensation insurance.

What are the Employer conditions?

As the employer, you must present each DCW with the Employment Agreement before they can be paid as a DCW. This document needs to be signed and dated by the DCW and yourself before PPL can issue a paycheck for services rendered. The Employment Agreement will establish a hire date, wage rate and job title, as well as provide important information to the DCW about employment policies and rules.

Who is responsible for submitting timesheets to PPL?

As an employer, it is your responsibility to see that timesheets are submitted to PPL in a timely manner.

Do my DCWs have to complete paperwork too?

Yes. Each DCW needs to complete all required forms before starting work. Please notify PPL and your Support Coordinator when you hire a DCW. DCW forms can be found online at www.publicpartnerships.com or can be sent by mail upon request by contacting PPL customer service.

If you have any questions, please contact one of our Customer Service Representatives at 1-877-908-1750. Our customer service team is available Monday through Friday 8:00am until 8:00pm EST and Saturday 9:00am to 1:00pm.

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IMPORTANT INFORMATION PLEASE READ BEFORE YOU CONTINUE

You may be wondering where your Payroll Schedule and Timesheet instructions are. PPL plans to send a second mailing to you with all of this information after you are determined to be “Good to Serve”. You will be considered “Good to Serve” once you and your direct care worker (DCW) review, sign, and complete all required paperwork, PPL will provide you with written notification (the second mailing) that you have successfully completed all of the necessary requirements. PPL will provide payment only for services that DCW(s) provide after receiving written notification. PPL must adhere to federal, state, and local tax laws. Therefore, all the employer and DCW paperwork must be signed and returned to PPL before payments can schedule your DCW(s) to start working.

Enrollment Requirements

Under the rules of Pennsylvania’s participant direction program, each direct care worker may not begin providing services until all of the following are complete: Your direct care worker (DCW)P correctly completes all required paperwork, which is

provided to the DCW in the enrollment packet Your DCW has successfully cleared the background checks, which PPL will conduct after

receiving the required paperwork Your DCW receives written notification from PPL, by mail, that he or she is good-to-go for

providing services to you

What does being “Good to Go” mean?

1. PPL has received and processed all required Common Law Employer documents andthey are signed and dated.

In this second mailing you will receive the following information:

1. Your PPL ID number2. PPL Payroll Schedule.3. Sample Paper Timesheet4. Paper Timesheet Instructions5. Electronic Timesheet Instructions6. Instructions on “How to Access and Use” the PPL Web Portal

Please note: You will be unable to register in the PPL Web Portal to view your authorizations or approve electronic timesheets until you have received a unique PPL ID number.

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What is the purpose of this form?

This form is used by Public Partnerships, LLC (PPL) to verify the demographic information of all Common Law Employers (CLE).

What lines do I complete? PPL has pre-populated this form with the information we have received from your existing F/EA. Please review the information on this form.

If it is correct, the Common Law Employershould sign the additional forms in thispacket.

If it is incorrect, please call or emailcustomer service immediately so that wecan send you a corrected Common LawEmployer packet.

If you are serving as the CLE for multipleparticipants, please remember to indicatethis at the bottom of the form.

If you have any questions, please contact one of our Customer Service Representatives at 1-877-908-1750.

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MAIL FORM TO: PA OLTL PUBLIC PARTNERSHIPS, LLC P.O. BOX 61257 HARRISBURG, PA 17106-1257


What is it for? When a participant has chosen the self-directed service delivery option and is enrolling with Public Partnerships, LLC, with the Common Law Employer Designation (CLE) form participants have the option to designate a representative to help them direct their care in the event that they (the participant) is unable to direct their own care independently.

Part 1: Common Law Employer Designation: (a) One box must be checked.

(b) Please check the first box if the individual is able to self-direct and manage their Participant Directed Services (PDS) independently. After the first box is checked and the individual's name is entered in the space provided, stop filling out the form and skip to the signatures section.

(c) Please check the second box if the participant is not able to self-direct and manage their Participant Directed Services (PDS) independently. This indicates the participant has determined that they will benefit from having an alternate common law employer designated to assist them with making decisions regarding the use of PDS. After the second box is checked, please enter the names of the individual and the person being designated as the common law employer in the spaces provided. Continue filling out the designated common law employers contact information.

(d) Please check the third box if the participant is not able to self-direct and manage their Participant Directed Services (PDS) independently. Checking this box indicates the individual's legal guardian or power of attorney has determined that the individual will benefit from having an alternate common law employer designated to assist the individual with making decisions regarding the use of PDS. After the third box is checked, please enter the names of the legal guardian or power of attorney as applicable,

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and the person being designated as the common law employer in the spaces provided. Continue filling out the designated common law employer contact information.

Part 2: Designated Common Law Employer Contact Information:

Please enter the designated common law employer contact information as applicable in the spaces provided.

Part 3: Common Law Employer Responsibilities and Attestation:

The common law employer or person being designated as the common law employer must enter their name in the space provided and read the attestation. By signing where applicable, the common law employer is stating they understand the responsibilities and agree to maintain compliance with what is written in this section.

Section 4: Signatures:

a) The participant must sign and date the form.b) The designated common law employer should sign and date the form if the participant is

not the common law employer.c) The legal guardian or power of attorney (as applicable) should only sign and date the

form if the third box was checked in the common law employer designation section.




The common law employer (CLE) must complete and submit the Common Law Employer Agreement to Public Partnerships, LLC. 1. Participant’s information: The participant’s

information must be completed.2. Common law employer designation: One box must be

checked to identify whether the participant or theparticipant’s surrogate/representative is the CLE.

3. Designated CLE information: If an alternate commonlaw employer has been designated to act as the CLE, theindividual’s information must be completed.

4. Common law employerrequirements/responsibilities: The participant ordesignated common law employer (as applicable) mustbe informed of the CLE requirements andresponsibilities and agree to maintain compliance withthe responsibilities of being the CLE. If the designatedcommon law employer has questions regarding the CLEresponsibilities, please contact Public Partnerships,LLC.

5. Attestation box and signature: The common lawemployer’s name must be entered in the attestation boxand read the attestation. By signing, printing and datingthe Common Law Employer Agreement, the participant ordesignated common law employer (as applicable) isagreeing to the CLE requirements and responsibilities, andterms and conditions of being designated as the CLE.

6. Maintain copy in file:a. The CLE must maintain a copy of the Common Law

Employer Agreement.b. The CLE must provide a copy to Public

Partnerships, LLC.c. Public Partnerships, LLC is responsible to maintain

a copy of this form.


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What is it for? This form tells the IRS that you are going to be an employer and is used to obtain an Employer Identification Number (EIN) from the IRS. This EIN is used to open state employer accounts and designate all tax deposit and filing responsibility to PPL.

Why isn’t my address listed on lines 4a and 4b? Lines 4a and 4b ask for the mailing address to be attached to this employer account. PPL does not intend to burden you with IRS paperwork. By establishing PPL’s address as the mailing address on your employer account, PPL ensures that you will not receive IRS paperwork relating to this program at your home.

Who are the people listed in the ‘Third Party Designee’ section? Those are PPL staff members who are experienced obtaining EINs on behalf of Individual Employers. These three individuals are the only people who can obtain an EIN on your behalf.

What lines do I complete? PPL has completed the SS-4 in a way that notifies the IRS that even though you will be the official employer of your service providers, you will be using PPL to file and deposit your employer taxes. If you have applied for an EIN in the past, complete lines 16a, 16b and 16c. You also must sign and date the bottom of the form.


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MAIL FORMS TO: PA OLTL PUBLIC PARTNERSHIPS, LLC P.O. BOX 61257 HARRISBURG, PA 17106-1257


What is it for? This form tells the IRS that you give PPL permission to do some work for you. By signing this form, you authorize PPL to withhold taxes from your employees’ paychecks and deposit those taxes with the IRS. With this form, you delegate the employer tax responsibility to PPL.

If I appoint you as my agent with the IRS Form 2678, what will you be able to do? The IRS Form 2678 only allows us to withhold taxes from your employee’s paychecks and deposit those taxes to the IRS. This form is only recognized by the IRS; other tax agencies do not recognize this form. The 2678 does not authorize us to perform any other tax responsibilities.

What liability does PPL take on when I sign the 2678? The IRS Form 2678 subjects PPL to all provisions of law, including penalties that the employer incurs. When you authorize PPL as your agent with Form 2678, PPL is responsible by law for correctly representing you. PPL incurs any penalties of misfiling or incorrectly depositing your employer taxes.

Does the IRS Form 2678 authorize you to file my personal income taxes? No. PPL only deposits withholding taxes for your employees. PPL cannot handle any of your personal income tax matters.

What sections do I complete? Most of this form is completed for you.

All you need to do is review, sign, and date the form, and return it to PPL.


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What is it for? This form allows PPL to discuss your employer withholding account with the IRS. It does not allow these representatives to sign any documents.

How is this different than the IRS Power of Attorney form? The IRS Power of Attorney Form allows PPL’s CPA only to sign employer tax reports. This form allows 3 specific PPL representatives to talk and write to the IRS about your employer tax account.

Will PPL be able to discuss my personal tax account with the IRS? No. PPL, your Fiscal Management Service (FMS) will only be able to discuss the employer tax forms listed in Section 3b. PPL will never be able to obtain any personal income tax information.

I make all decisions about my life. If I sign this, what decisions can PPL make for me? This form only lets PPL talk and write to the IRS. PPL cannot make decisions about your personal life.

What lines do I complete? PPL has completed most information for you, but you must sign and date this form in Section 7.


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Table 1

Region Service Maximum DCW

Hourly Wage Rate

Region 1 PAS $11.50

Region 1 Respite $11.26

Region 2 PAS $10.99


Region 3 PAS $12.04


Region 4 PAS $13.52


Table 2

Region 1 Region 3 Region 4

Allegheny Bedford Jefferson Susquehanna Adams Bucks

Armstrong Blair Lackawanna Tioga Berks Chester

Beaver Bradford Lawrence Union Carbon Delaware

Fayette Butler Lycoming Venango Cumberland Montgomery

Greene Cambria Luzerne Warren Dauphin Philadelphia

Washington Cameron McKean Wayne Franklin

Westmoreland Centre Mercer Wyoming Fulton

Clarion Mifflin Huntingdon

Clearfield Monroe Juniata

Clinton Montour Lancaster

Columbia Northumberland Lebanon

Crawford Pike Lehigh

Elk Potter Northampton

Erie Snyder Perry

Forest Somerset Schuylkill

Indiana Sullivan York

Revised: Aug-14

NEW Employer Maximum DCW Hourly Wage Rate Sheet

Region 2

Each Participant/Direct Care Worker (DCW) may negotiate a DCW hourly wage for each service provided.

The chart below shows the maximum DCW Hourly Wage Rate you may pay a DCW in your region. If you are a

newly referred Participant/CLE you will use the Maximum Wage Rate Breakdown Sheet provided in your

initial enrollment package. The maximum wage rate breakdown sheet is specific to new employers only.

Please note that the maximum DCW Hourly Wage Rate is subject to change if unemployment or workers

compensation insurance rates change. To manage these employer costs, each Participant should actively

monitor worker safety and staff turnover.


Your BAMS contacts are:

Babb Absence Management Services (Third Party Administrator)

850 Ridge Avenue Pittsburgh, PA 15212-6095

Toll Free #: 1-800-892-1015 (PA) Toll Free #: 1-800-245-6102 (All Others)

Fax: 1-412-322-1756

WORKERS’ COMPENSATION CLAIMS TEAM Lost Time Injuries: Loss Control:

Interim Contact: Carolyn Lyle James Stapleton (412) 237-2038 (412) 237-2143

[email protected] [email protected] Medical Injuries Only: President:

Christina Kenny Donna Greiner (412) 237-2123 (412) 237-2032

[email protected] [email protected] Claims Manager:

Janice Evans (412) 237-2112

[email protected]

Other Contacts... Anthony Hewitt Dan Gass [email protected] [email protected] Phone: 412-237-2122 Phone: 412-237-2132

BABB, Inc. Fax: 412-322-1756 Fax: 412-322-1756 Ed Shea Mark Elliott [email protected] [email protected] Phone: 412-237-2008 Phone: 412-237-2145 Fax: 412-322-1756 Fax: 412-322-1756 Leon Williams [email protected] Phone: 412-237-2117Fax: 412-322-1756

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Insurance Broker: Babb, Inc. Insurance Carrier: AmTrust Insurance Company

In the event of a claim, please contact: Karen Graves @ 1-877-908-1750

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The Common Law Employer (CLE) must complete and submit the Address/Phone Change Form, to Public Partnerships, LLC (PPL) when a CLE address and phone contact information has changed

UPDATE QUALIFIED DCW INFORMATION

1. Select the Common Law Employer: Check theappropriate box to identify “Who” is acting as theCLE.

2. Select the Type of Change: Check all changes toeither the CLE address, or phone number.

3. Participant PPL ID: Print or type the ParticipantPPL ID number to specifically identify theappropriate record to change.

4. Common Law Employer Address: Print or type theold and new address of the CLE in the spaceprovided.

5. Common Law EmployerTownship/Borough/School District: Print or typethe current township, borough, or school district inthe space provided.

6. Common Law Employer Phone Number: Print or type the old and new phone number of the in thespace provided.

7. Common Law Employer Signature and Date: The CLE whose information has changed must verifythe new information reported on the form by signing and dating the form in the space provided.

Next Steps:

Once the CLE has completed the form, signed and dated the form, as appropriate, it should be submitted to PPL within two (2) business day of the CLE being informed of any changes.

If you have any questions, please call PPL at 1-877-908-1750.

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Included in this packet is a Vendor Payment Request Form. This form is ONLY for those Participants who are enrolled in Services My Way and receive Participant Directed Goods and Services (PDGS) as part of their ISP. If you are eligible to receive PDGS you should complete and submit the Vendor Payment Request Form to Public Partnerships, LLC (PPL) in order for a vendor payment to be issued. Participant’s information: The participant’s identification information must be completed. Payment Instructions: Enter the company or individual’s information that is being paid for the service in the Make check payable to field, FEIN or SS# field, and their address information. If the individual who provided the service is different than the payee, enter their information at the end of the payment instructions. Service Information: Enter the service information and the total amount in the bottom right corner of the table. If the request for payment is for transportation mileage costs, enter the date range of service under date, and total miles in the description. If the payment request is for transportation mileage, the Request for Vendor Payment: Transportation Log must be completed and attached to the Request for Vendor Payment form when it is submitted by the CLE to PPL. Attestation box: The CLE must read and sign the attestation. By signing, and dating the Request for Vendor Payment, the CLE is agreeing to the terms and conditions the Request for Vendor Payment form. Submit to VF/EA FMS organization: The CLE must submit the completed original Request for Vendor Payment to PPL.

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Please verify the following qualifications for the person or entity that provides the participant-directed services. OLTL Vendor services are: Participant-Directed Goods and Services. Qualification

validated Qualification Requirement

Provider Type

At least 18 years of age Individual

Have the required skills to perform Participant-Directed Goods and Services as specified in the consumer’s service plan

Individual

Possess a valid Social Security number Individual

Meets applicable state and local regulations and/or Medicaid provider qualifications for the type of service the provider/supplier is providing as written in the participant’s Spending Plan.

Individual or Agency

Meets the acceptable industry standards for the goods or services they provide

Individual or Agency

Has entered into a Medicaid provider agreement with each provider on behalf of the State Medicaid Agency (DPW)

Agency

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