VCG’s VANTAGE
A view into the latest Benefits and HR topics
2Apr 2019

Court Invalidates New Association Health Plan Rule

Authors: |Benefits, In The Know|0 Comments

On March 28, 2019, a judge for the United States District Court for the District of Columbia ruled against the Department of Labor (DOL) by invalidating critical aspects of the new association health plan rule (the Rule). In its decision, the Court found the Rule to be an unreasonable interpretation of the Employee Retirement Income Security Act (ERISA) and labeled [...]

27Mar 2019

Medicare Secondary Payer Rules

Authors: |Administration, Benefits, Compliance, In The Know|0 Comments

The Medicare Secondary Payer (MSP) rules impose regulations on group health plans that govern how plans interact with Medicare and Medicare-entitled plan participants. While complex, the rules are designed to spread costs between Medicare and group health plans that are considered primary payer to Medicare. Employer-sponsors of group health plans that are subject to the MSP rules must comply with [...]

15Feb 2019

Checklist for Self-funded Group Health Plans

Authors: |Administration, Benefits, Compliance, In The Know|0 Comments

Group health plans are subject to an ever-changing environment of regulations surrounding compliance and notice obligations. Many of the requirements apply equally to both insured and self-funded arrangements, and the insurance carrier often ensures compliance with certain items. This checklist provides an overview of the obligations for self-funded group health plans. Employers sponsoring self-funded plans should monitor these requirements closely and [...]

27Dec 2018

Nondiscrimination Rules for Section 125 Plans and Self-funded Health Plans

Authors: |Administration, Benefits, Compliance, In The Know|0 Comments

The IRS imposes nondiscrimination rules on Section 125 plans (also known as flexible benefit plans, cafeteria plans or pre-tax premium plans) and self-funded group health plans.  The purpose of the rules is to prevent employers from favoring highly compensated employees to an impermissible degree.  The general consequence of the failure of the tests is that the highly compensated employees will [...]

27Dec 2018

PCORI Fee Amount Adjusted for 2018

Authors: |Administration, Benefits, Compliance, In The Know|0 Comments

The Affordable Care Act (ACA) imposes a fee on fully-insured health plans and self-funded company plan sponsors in order to fund comparative effectiveness research. These fees are widely known as Patient-Centered Outcomes Research Institute (PCORI) fees.  The Internal Revenue Service (IRS) increased the fee to $2.45 for 2018.  Here are the highlights. The IRS published Notice 2018-85, which increased the PCORI [...]