A view into the latest Benefits and HR topics
2Nov 2018

Required Reporting, Disclosures and Notices for Group Health Plans

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

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 employee can share that information [...]

23Oct 2018

Annual Enrollment Checklist

Authors: |Benefits, Communications, Compliance, Human Resources, In The Know|0 Comments

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, it is important for employers [...]

20Sep 2018

Medical Loss Ratio (MLR)

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

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 small group and individual markets [...]

28Aug 2018

Medicare Part D Notices – Creditable (or Non-Creditable) Coverage

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

Plan sponsors of group health plans providing prescription drug coverage to individuals who are eligible for Medicare Part D prescription drug coverage are required to satisfy certain notice requirements. Background Individuals must enroll in Medicare Part D prescription drug coverage when first eligible (generally, at age 65).  If they do not do so, they are subject to a permanently higher [...]

23Aug 2018

When Can SPDs and Participant Notices be Distributed Electronically?

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

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 must distribute SPDs and other [...]