Month: March 2015
Definition of “Spouse” Updated for FMLA
The Department of Labor has issued an updated definition for “spouse” under the Family and Medical Leave Act (FMLA) to make compliance with FMLA easier for both employers and employees. The new regulations will be effective on March 27, 2015, and will define “spouse” as a husband or wife, which...
Read MoreFinal Rule Issues Standards for Insurers and Marketplaces in 2016
Recently, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services issued a Final Rule with standards for insurers and Marketplaces in 2016, covering topics such as transparency in health insurance rate increases, formulary drug lists, drug mail order opt out provisions, determination of minimum...
Read MoreGrowing Pains: Why Adolescence Is About To Get That Much Harder
Employers that are growing up, and are in the awkward teenage years, are about to get a big surprise, and not the good kind. When a company first opens, they are excited when they first implement their benefit plans for their handful of employees. They offer one or two medical...
Read MoreIRS Provides Details on Reimbursing Premiums for Individual Health Coverage or Medicare Part B, Part D, or Medigap for Active Employees
On February 18, 2015, the Internal Revenue Service (IRS) issued Notice 2015-17. This Notice addresses employer payment or reimbursement of individual premiums in light of the requirements of the Patient Protection and Affordable Care Act (PPACA). For many years, employers were permitted to reimburse premiums paid for individual coverage on a...
Read MoreAgencies Provide Guidance on Single Benefit Products and Excepted Benefits
On February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits. Many provisions of PPACA do not apply to excepted health benefits. Supplemental excepted benefits are those that are provided under a separate...
Read MoreIRS Requests Input on the Cadillac Tax
Beginning in 2018, plans that provide coverage that exceeds a threshold will owe an excise tax that is frequently referred to as the “Cadillac tax.” The threshold generally will be $10,200 for single benefits and $27,500 for benefits provided to an employee, retiree, or member of a bargaining unit and...
Read MoreThink 2014 tax forms are bad? Here come the 1094 and 1095 for 2015!
Our recent blog reviewed the highlights of the new employer and insurer reporting requirements. The chart below is designed to help you sort out who should use which form, and when: For comprehensive information on coverage requirements, due dates, special circumstances, controlled groups and how to complete the forms—including sample situations—...
Read MoreHighlights of Employer and Insurer Reporting Requirements
The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption. Employers with 50 or more employees that do not offer affordable, minimum value coverage to their full-time employees also will...
Read MoreThe RFP vs. the Two Step Process — Choosing Group Health Insurance
Many employers look at employee benefits as a commodity, bidding out their plans annually — and who can blame them? Rising health care costs coupled with a challenging economic environment have forced many human resources decision-makers to focus heavily on cost. Organizations of all sizes struggle to find a balance...
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