In The Know

/In The Know
A view into the latest Benefits and HR topics

Court Invalidates New Association Health Plan Rule

Authors: |April 2nd, 2019|Benefits, In The Know|

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 [...]

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 [...]

Despite Judge’s Ruling, the Affordable Care Act Remains in Full Effect

Authors: |December 18th, 2018|Benefits, Compliance, In The Know|

On Friday, December 14, a federal judge in Texas ruled that without the individual mandate penalty, the Affordable Care Act (ACA) is unconstitutional and the entire law is invalid. While this decision signals the start of another legal battle over the future of the ACA, it does not have any immediate impact. As part of [...]

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 [...]

Annual Enrollment Checklist

Authors: |October 23rd, 2018|Benefits, Communications, Compliance, Human Resources, In The Know|

For employers operating their group health plans on a calendar year basis, now is the time of the year to prepare for open enrollment with respect to group health and welfare benefits.  Typically, the focus is on evaluating the services and performance of vendors, renewing rates and considering design changes.  In addition to these items, [...]