Administration

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A view into the latest Benefits and HR topics

Medicare Secondary Payer Rules

Authors: |March 27th, 2019|Administration, Benefits, Compliance, In The Know|

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 [...]

Checklist for Self-funded Group Health Plans

Authors: |February 15th, 2019|Administration, Benefits, Compliance, In The Know|

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 [...]

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

Authors: |December 27th, 2018|Administration, Benefits, Compliance, In The Know|

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 [...]

PCORI Fee Amount Adjusted for 2018

Authors: |December 27th, 2018|Administration, Benefits, Compliance, In The Know|

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 [...]

IRS Extends ACA Reporting Deadline (Again)

Authors: |December 4th, 2018|Administration, Benefits, Communications, Compliance, In The Know, Technology|

In the recently released Notice 2018-94, the IRS provided reporting relief for employers for the 2018 calendar year.  Here are the key points. The due date for providing Forms 1095-C or 1095-B to employees and individuals is extended 32 days to March 4, 2019 Despite the extension, the IRS is encouraging reporting entities to furnish [...]

IRS Announces 2019 Health FSA and Commuter Contribution Limits

Authors: |November 15th, 2018|Administration, Benefits, Compliance, In The Know|

The IRS announced annual adjustments to Health Care Flexible Spending Accounts and Parking and Transit Accounts. Benefit Plan 2018 Limit 2019 Limit Health FSA $2,650/year $2,700/year Parking and Transit Account $260/month $265/month   Employers are not required to increase their Health FSA to reflect the new limit.  It may not be administratively feasible for groups [...]

Required Reporting, Disclosures and Notices for Group Health Plans

Authors: |November 2nd, 2018|Administration, Benefits, Communications, Compliance, In The Know|

Participants must be provided with various notices in connection with an employer’s group health plan.  The notices are required at certain intervals including initially, upon annual open enrollment and at termination. Notices with Initial Enrollment Materials Notice of Exchange Availability. This notice must contain certain basic information about the employer’s group health coverage so the [...]

Medical Loss Ratio (MLR)

Authors: |September 20th, 2018|Administration, Benefits, Communications, Compliance, In The Know|

The Affordable Care Act (ACA) requires health insurance issuers to spend a minimum percentage of premium dollars on medical care and health care quality improvement, which is intended to lower the cost of care. This percentage is known as "medical loss ratio" (MLR). In the large group insurance market, the required MLR is 85%; the [...]

When Can SPDs and Participant Notices be Distributed Electronically?

Authors: |August 23rd, 2018|Administration, Benefits, Communications, Compliance, In The Know, Technology|

Summary Plan Description (SPD) is a document that employers are required to give to employees in retirement plans or health benefit plans covered by ERISA.  The SPD is simply a summary of the plan document required to be written in such a way that the participants of the benefits plan can easily understand it. Employers [...]

U.S. News Best Hospitals Rankings 2018-2019

Authors: |August 22nd, 2018|Administration, Benefits, Decision Making, In The Know, Technology, Workplace Wellness|

On August 14th, U.S. News and World Report released their annual top hospitals rankings. The top five nationally were: Mayo Clinic, Rochester, MN Cleveland Clinic Johns Hopkins Hospital, Baltimore Massachusetts General Hospital, Boston University of Michigan Hospitals-Michigan Medicine Ann Arbor They also reported regional rankings for 200 metropolitan areas and the top five hospitals in selected [...]