Compliance
Federal Agencies Announce Pause on MHPAEA Final Rule Enforcement
The Consolidated Appropriations Act, 2021 (CAA) required medical plans to conduct a comparative analysis of the non-quantitative treatment limitations (NQTLs) under the plan. For the first few years following the enactment of the CAA, these rules were in a proposed state; however, in late 2024 the Department of Labor (DOL),...
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IRS Issues 2026 HSA and EBHRA Limits
The IRS issued Revenue Procedure 2025-19, to announce the 2026 inflation-adjusted amounts for health savings accounts (HSAs), High-Deductible Health Plans (HDHPs) under the Internal Revenue Code (Code) and the maximum amount employers may contribute for excepted benefit health reimbursement arrangements (EBHRAs). The new HSA and HDHP limits will go into effect...
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HHS Releases HIPAA Security Proposed Rules
In light of ongoing cybersecurity concerns related to HIPAA protected information and the Department of Labor’s guidance, which reiterated its focus on cybersecurity, the Department of Health and Human Services Office for Civil Rights (OCR) issued a notice of proposed rulemaking (NPRM) to the Security Rule under the Health Insurance...
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RxDC Reporting Due June 1, 2025
The Centers for Medicare and Medicaid Services (CMS) has updated the Prescription Drug Data Collection (RxDC) resources. The updates include changes to the RxDC Reporting Instructions and new RxDC templates and data dictionary. As a reminder, the RxDC reporting was established as part of the transparency rules under the Consolidated Appropriations Act 2021...
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Court Dismisses ERISA Fiduciary Class Action Against Johnson & Johnson
On January 24, 2025, the U.S. District Court of New Jersey dismissed two fiduciary breach claims in Lewandowski v. Johnson & Johnson, et al. (“Lewandowski”). In Lewandowski, the plaintiffs alleged Johnson & Johnson (“J&J”) breached its fiduciary duties to plan participants and beneficiaries by mismanaging its prescription drug plans when...
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Medicare Part D Creditable Coverage Disclosure Due to CMS by March 1, 2025, for Calendar Year Plans
The Medicare Modernization Act (MMA) established annual notification requirements for employer-sponsored group health plans with prescription drug coverage. Per the MMA, employers sponsoring these plans are required to disclose annually the creditable status of the plan to The Centers for Medicare and Medicaid Services (CMS). This disclosure is due to...
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ACA Reporting Amendments Apply to Upcoming Reporting
President Biden signed two bills, Employer Reporting Improvement Act and the Paperwork Burden Reduction Act, into law which provide helpful updates to the Affordable Care Act’s (ACA) reporting requirements under Internal Revenue Code (IRC) Sections 6055 or 6056. The amendments are in effect for the 2024 reporting, which is due...
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Updates for High Deductible Health Plans
Telehealth Flexibility Sunsetting in 2025 As a result of the CARES Act in 2020, HDHPs were permitted to provide first dollar telehealth coverage without negatively impacting HSA eligibility. This relief initially sunset in 2023. The Consolidated Appropriations Act, 2023 provided a two-year extension of the relief, with will not expire...
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Deadline Approaching: HIPAA Rules to Limit the Use and Disclosure of PHI Related to Reproductive Health Care
As a result of the overturning of Roe v. Wade, the Department of Health and Human Services (HHS) released final rules aimed at ensuring the privacy of protected health information (PHI) related to lawful reproductive health care. Under the new rule, HIPAA-covered entities will be required to obtain signed attestation...
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Gag Clause Prohibition Compliance Attestation Due by December 31, 2024
Background When the Consolidated Appropriations Act, 2021 (CAA) was enacted by Congress on December 27, 2020, the law included a provision preventing group health plans and health insurance carriers from entering into health plan services contracts (such as a third-party administrator or health care provider contracts) with gag clauses...
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Delaware Paid Family and Medical Leave Opt-Out Deadline is Approaching
Overview of Delaware PFML: Starting January 1, 2026, Delaware’s PFML program will provide paid leave benefits to employees who have been employed for at least one year and have worked at least 1,250 hours in the most recent 12 months for various qualifying events, including: Caring for a new child...
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MLR Rebates Due to Plan Sponsors by September 30, 2024
MLR Rebates Due to Plan Sponsors by September 30, 2024 The Affordable Care Act (ACA) outlines the requirements private health insurance issuers must follow, including obligations related to premium spending. The ACA requires health insurers to spend at least 80% to 85%, depending on the size of the market, of...
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IRS Releases ACA Affordability Threshold for 2025
IRS Releases ACA Affordability Threshold for 2025 The IRS released Rev. Proc. 2024-25, announcing an increase in the ACA Affordability Contribution Rate from 8.39% in 2024 to 9.02% for the 2025 plan year. After three years of decreases in the ACA affordability threshold, this increase may be seen as welcome...
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RetireReady NJ Exemption Registration is Fast Approaching!
RetireReady NJ Exemption Registration is Fast Approaching The New Jersey Secure Choice Savings Program Act requires certain New Jersey employers to establish a retirement savings program through the RetireReady NJ program, if they do not already sponsor a retirement savings plan. Once the program is established by the employer, New...
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Court Issues Nationwide Block on the FTC’s Non-Compete Ban
The Court for the Northern District of Texas (the Court) issued a decision blocking the Federal Trade Commission’s (FTC) ban on non-compete agreements, which was set to go into effect September 4, 2024. The ban would have invalidated non-compete clauses, which typically prohibited workers from their previous employer’s competitor or...
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Upcoming Changes for HDHP Plan Sponsors Under Medicare Part D
Employers who sponsor group health plans must act now regarding the status of their prescription drug coverage in advance of changes to Medicare Part D that go into effect for 2025. The Inflation Reduction Act of 2022 (IRA) made changes to Medicare Part D to enhance benefits and enrollee cost...
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IRS Releases Education Assistance FAQs
The IRS recently released a Fact Sheet to address frequently asked questions related to educational assistance programs offered under IRC Section 127. Programs offered under this section allow employees to receive a tax-exempt benefit while providing employers with a tax deduction. The IRS noted that this Fact Sheet should not...
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PCORI Fee Due July 31, 2024
The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In Notice 2023-70, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan years that end on or after October 1, 2023, and...
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IRS Issues 2025 HSA and EBHRA Limits
The IRS issued Revenue Procedure 2024-25, to announce the 2025 inflation adjusted amounts for health savings accounts (HSAs), High Deductible Health Plans (HDHPs) under the Internal Revenue Code (Code) and the maximum amount employers may contribute for excepted benefit health reimbursement arrangements (EBHRAs). The new HSA and HDHP limits will go...
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Johnson & Johnson Class Action Lawsuit
Johnson & Johnson Class Action Lawsuit In early February, a federal class action lawsuit was filed against Johnson & Johnson (JNJ) and its plan fiduciaries, alleging overpayment for prescription drugs within its prescription drug plan. The complaint alleges that under the Employee Retirement Income Security Act of 1974 (ERISA), JNJ’s...
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SECURE 2.0: IRS Issues Guidance on De Minimis Financial Incentives and Employer Roth Contributions
The Secure Act 2.0 has been signed into law with the goal of promoting retirement security among Americans. The bill contains dozens of provisions that will impact various aspects of retirement plans. As a plan sponsor, it’s important to understand how the Secure Act 2.0 will impact your organization and...
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Civil Monetary Penalties Announced for 2024
Civil Monetary Penalties Announced for 2024 The Department of Labor (DOL) has announced the Civil Monetary Penalties for 2024. Federal agencies are required to review the penalty amounts annually to adjust for inflation, a requirement established in 2015 as part of the Federal Civil Penalties Inflation Adjustment Act Improvements Act....
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Cyber-threat Reported by Change Healthcare and UnitedHealth Group
On February 21, 2024, Change Healthcare released information regarding a cybersecurity issue resulting in an enterprise-wide network interruption. Change Healthcare is part of the health services provider Optum, Inc., which is owned by UnitedHealth Group. By Thursday, February 22nd, both Change Healthcare and UnitedHealth acknowledged the issue and announced it...
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RxDC Reporting due to CMS by June 1, 2024
The Centers for Medicare and Medicaid Services (CMS) has updated the Prescription Drug Data Collection (RxDC) resources. The updates include changes to the RxDC Reporting Instructions and new RxDC templates and data dictionary. As a reminder, the RxDC reporting was established as part of the transparency rules under the Consolidated...
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New Employee Classification Rule
In January, the Department of Labor (DOL) Wage and Hour Division introduced a rule that changes the way workers are classified under the Fair Labor Standards Act (FLSA). This Final Rule, effective March 11, 2024, offers a more comprehensive test to determine a worker’s status, potentially making it more challenging...
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Medicare Creditable Coverage Disclosure Due to CMS by March 1, 2024
The Medicare Modernization Act (MMA) established annual notification requirements for employer-sponsored group health plans with prescription drug coverage. Per the MMA, employers sponsoring these plans are required to disclose annually the creditable status of the plan to The Centers for Medicare and Medicaid Services (CMS). This disclosure is due to...
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Guidance On Coverage For Contraceptives
The Affordable Care Act (ACA) Implementation FAQs Part 64, issued on January 22, 2024, provide guidance on preventive service coverage. Prepared by the Departments of Labor, Health and Human Services, and the Treasury, they aim to enhance understanding and compliance with the law and specify that non-grandfathered health plans must...
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2024 ACA Reporting Code Reference Sheet
2024_ACAReportingCodesReference 2024_ACAReportingCodesReference
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IRS Issues Additional Guidance for SECURE 2.0 Act
In an effort to provide necessary clarity for employers and plan sponsors, the Internal Revenue Service (IRS) issued long-awaited guidance for various provisions under the SECURE 2.0 Act (SECURE 2.0). This guidance comes in Question-and-Answer format and addresses twelve of the 90+ provisions under SECURE 2.0. Specifically, provisions related to...
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IRS Releases 401(k) Guidance For Long-Term Part-Time Employees Under the Secure 2.0 Act
On November 24, 2023, the IRS released long-awaited guidance around the updated 401(k) eligibility requirements pertaining to long-term part-time employees (LTPT) under the SECURE 2.0 Act of 2022 (SECURE 2.0). These proposed regulations, if finalized, would amend the rules previously applicable to 401(k) plans and provide additional clarification for some...
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IRS Issues 2024 FSA and Commuter Limits
On November 9, 2023, the IRS released the long awaited 2024 maximum contribution limits for Flexible Spending Arrangements (FSA) and Commuter accounts. A bit later than usual, Revenue Procedure 2023-34 follows the IRS’s announcement of the 2024 401(k) annual contribution limits, which were released November 1st. For taxable years...
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Departments Move Forward with Enforcement of Deferred Machine-Readable File Requirement
The Departments of Labor, Health and Human Services and Treasury (The Departments) have released updated FAQs around the requirement for plans and issuers to post machine-readable files on a public website. Per the Consolidated Appropriations Act, 2021 (CAA), plans and issuers were required to post, in three separate machine-readable files,...
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Joint Agency Guidance on Gag Clause Prohibition for Health Plan Agreement
On February 23, 2023, the Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) (the “Agencies”) released FAQs addressing the implementation of certain transparency requirements under the Consolidated Appropriations Act of 2021 (CAA). These joint-issued FAQs address additional compliance guidance on...
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IRS Delays Roth Catch-Up Contribution Requirement under SECURE 2.0 Act
In light of concerns expressed by plan sponsors and participants alike, the IRS released Notice 2023-62 (“Notice”) which provides a two-year extension on the requirement related to Roth catch-up contributions under SECURE 2.0 Act (“the Act”). Specifically, the Notice states, “The Department of Treasury and the IRS have been made...
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EEOC Announces 2022 EEO-1 Component 1 Submission Deadline
The U.S. Equal Employment Opportunity Commission (EEOC) has announced that the 2022 EEO-1 Component 1 data collection deadline for employers to submit demographic data. For 2022, data collection will begin on October 31, 2023. Eligible employers have until December 5, 2023, to submit their EEO-1 reports. The EEO-1 Component 1...
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IRS Releases ACA Affordability Threshold for 2024
The IRS released Rev. Proc. 2023-29on August 23, 2023, announcing a decrease in the ACA Affordability Contribution Rate from 9.12% in 2022 to 8.39% for the 2024 plan year. This is an even greater decrease from what was announced for the 2023 tax year, which was formerly the most significant...
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Notice of Proposed Rulemaking Released for the Pregnant Workers Fairness Act
The U.S. Equal Employment Opportunity Commission (EEOC) has issued a Notice of Proposed Rulemaking around the implementation of the Pregnant Workers Fairness Act (PWFA). The proposed rule, released for inspection August 7, 2023, aims to provide some needed clarification for employees and employers as they navigate the requirements under PWFA....
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New FAQ On No Surprise Act
Recently, the Departments of Labor, Treasury, and Health and Human Services (the “Departments”) released new frequently asked questions (FAQs) on the No Surprises Act and the Transparency in Coverage final rules, giving employers more guidance and clarity around health plan out-of-network providers and fee disclosures. Under the Affordable Care Act...
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MHPAEA Opt-Out Expires
The Centers for Medicare & Medicaid Services (CMS) has issued guidelines regarding changes to the Mental Health Parity and Addiction Equity Act (MHPAEA) for self-insured non-federal governmental health plans. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure...
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IRS Issues Guidance Related to Taxability of Wellness Indemnity Plan Payments
The IRS issued its fourth Chief Counsel Advice 202323006 (the “CCA”) to address the tax treatment of payments made to employees through employer-funded fixed indemnity insurance policies. Specifically, the guidance speaks to how wellness indemnity payments should be treated in the event an employee has unreimbursed out-of-pocket medical expenses related...
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DHS Terminates I-9 Form Remote Option Flexibility; Considerations for Remote Workers
For employers that remotely verified I-9 forms during the pandemic, the deadline for completing in-person verification is fast approaching. As background, the Department of Homeland Security (DHS) had provided additional flexibility due to COVID-19 to review I-9 documentation remotely and had previously announced that employers would have until July 31,...
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Pregnant Workers Fairness Act Goes Into Effect
Part of the Consolidated Appropriations Act, 2022, effective June 27, 2023, the Pregnant Workers Fairness Act (PWFA) requires employers with 15 or more employees to provide reasonable accommodations for job applicants and employees with known limitations related to pregnancy, childbirth and related medical conditions. The PWFA covers only accommodations and does not...
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PCORI Fee Due July 31, 2023
The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In Notice 2022-59, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan years that end on or after October 1, 2022, and...
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IRS Issues 2024 HSA and EBHRA Limits
The IRS issued Revenue Procedure 2023-23, to announce the 2024 inflation adjusted amounts for health savings accounts (HSAs), High Deductible Health Plans (HDHPs) under the Internal Revenue Code (Code) and the maximum amount employers may contribute for excepted benefit health reimbursement arrangements (EBHRAs). Significant increases to the limits are a...
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Federal Appeals Court Issues Stay On ACA Judgement
The Fifth Circuit Court of Appeals has issued a stay on a lower court ruling striking down certain preventive care coverage mandates under the Affordable Care Act. On March 30, 2023, the U.S. District Court in the Northern District of Texas issued its final ruling invalidating provisions of the ACA’s...
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Federal Judge in Texas Strikes Down Key ACA Provision Regarding Preventive Care Services
On March 30, 2023, the U.S. District Court in the Northern District of Texas (Court) issued a final ruling invalidating certain provisions of the Affordable Care Act’s (ACA) preventive care mandate. Although the ultimate outcome of this decision remains to be seen, the ruling has created some confusion for plan...
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DOL Signals July 10 as End of COVID-19 Outbreak Period, Despite Early End to National Emergency
On Monday, April 10, 2023, President Biden signed Congress’s jointly-introduced H.J Res. 7 into law, ending the COVID-19 National Emergency immediately instead of on May 11, 2023, as previously announced. However, the Department of Labor (DOL) has unofficially signaled that its previous guidance issued on March 29, 2023, stands, including...
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Temporary Workers’ Bill of Rights Signed into Law in New Jersey
In early February 2023, Governor Phil Murphy signed the Temporary Workers’ Bill of Rights (the Bill) which expands the rights and protections afforded to temporary workers. The Bill is applicable to temporary laborers in a “designated classification placement,” which is defined as an assignment of a temporary laborer by a...
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President Biden Adopts the New Regulations Impacting Working Mothers
Congress recently passed, through the Consolidated Appropriations Act, 2023, the PUMP for Nursing Mothers Act (the Act) which makes several changes to the Break Time for Nursing Mothers law, enacted in 2010. Under the Break Time for Nursing Mothers law, employers nationwide were required to provide reasonable break time and...
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Internal Revenue Service Releases 2024 ACA Penalty Amounts
The Internal Revenue Service (IRS) released Rev. Proc. 2023-17, which outlines the inflation adjustments for the employer shared responsibility payments (ESRP) under the Affordable Care Act (ACA). Under the ACA’s pay or play rules, applicable large employees (ALEs) must offer affordable minimum-value health coverage to their full-time employees or be...
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President Biden Reveals Plan to End National COVID-19 Emergency
On January 30 President Biden issued a statement of policy to Congress in which he announced that the administration plans to end both the National Emergency related to COVID-19 originally declared by President Trump in 2020 and the public health emergency (PHE) declared by the U.S. Department of Health and...
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EEOC Updates Guidance Related to COVID-19 Workplace Testing
In recognition of the changing circumstances related to the COVID-19 pandemic, the EEOC has updated its guidance around conducting testing for on-site employees. Employers covered by the Americans with Disabilities Act must assess whether the current workplace circumstances within their organization justify COVID-19 testing, if they are continuing to test....
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Biden Administration Enacts Speak Out Act
Ahead of the close of the 117th U.S. Congress, the House of Representatives, with a vote of 315 – 109, quietly passed the Speak Out Act (“The Act”). President Biden signed the bill a few weeks later. Under the new law, nondisclosure and non-disparagement clauses related to allegations of sexual...
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Feds Extend Prescription Drug Filing Deadline, Announce Relaxed Enforcement
The Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) last week issued an FAQ that relieved filing entities from the December 27, 2022, deadline for providing certain information. The Departments understood many plans and carriers faced significant operational challenges in complying with the reporting requirements,...
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Continuing Appropriations Act Extends HDHP Relief for Telehealth Services
President Biden last week signed the Continuing Appropriations Act, 2023 (CAA 23) to provide funding for the federal government through the current fiscal year. But employers also should know there were some critical benefits-related provisions tucked into CAA 23. Though many of the benefits sections of CAA 23 related to...
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Employers Prepare For Rx Reporting Deadline
Section 204 of the 2021 Consolidated Appropriations Act (CAA) outlined several requirements for group health plans and health insurers aimed at targeting rising prescription drug costs. In an effort to bolster transparency, the CAA created new obligations for plans to report specific prescription drug data to The Centers for Medicare...
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Cafeteria Plans: Change in Status Events and Permissible Employee Election Changes
Cafeteria plans are governed by IRS Code Section 125 and allow employers to help employees pay for expenses such as health insurance with pre-tax dollars. Employees can choose between a taxable benefit (such as cash) and two or more specified pre-tax qualified benefits (health insurance, for example). Employees can select...
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Updated: Temporary Flexibilities for Remote Document Examination for Form 1-9 Extended
Temporary Flexibilities for Remote Document Examination for Form I-9 Extended Again In March 2020, the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) instituted a temporary policy which allowed employers with a remote workforce to defer physical presence requirements associated with Form I-9 and Section 274A...
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“Family Glitch” Final Rule Released
Published October 13, 2022, The Department of Treasury released finalized regulations that make the premium tax credit (PTC) for Marketplace health coverage available to more individuals starting in 2023. Under the Affordable Care Act (ACA) regulations, employer-based health insurance is deemed “affordable” if the employee’s contribution for self-only coverage does...
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Substantial Medical Loss Ratio Rebates Expected in 2022
Per the Kaiser Family Foundation, an estimated 8.2 million Americans will be due rebates for 2022. Further the analysis states that health insurers are expected to pay a total of $1 billion to policyholders. In light of this, plan sponsors should be prepared to handle any Medical Loss Ratio (MLR)...
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Health Plan Disclosure Requirements for Prescription Drugs
Under the Affordable Care Act (ACA) transparency-in-coverage (TiC) rules and provisions of the Consolidated Appropriations Act, 2021 (CAA), group health plan sponsors must both disclose and report detailed information regarding a plan’s prescription drug coverage and costs. There is significant overlap under the two sets of disclosure rules, which has...
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Departments Issue No Surprises Act FAQ and Clarify Independent Dispute Resolution Process
The U.S. Departments of Health and Human Services, Labor, and the Treasury (the “Departments”) recently released final rules regarding the No Surprises Act. The rules specifically address required independent dispute resolution (IDR) of certain claims and expenses and finalize prior interim final rules relating to information that group health plans...
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President Biden Signs Inflation Reduction Act Into Law
On August 16, 2022, President Biden signed the long-awaited Inflation Reduction Act which aims to reduce rising health care costs and greenhouse gas emissions, as well as raise taxes on corporations. The President’s signature comes after the House and Senate passed the bill last week along party lines following much...
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Biden Administration’s Fiscal Year 2023 Budget Calls for Increased Enforcement for MHPAEA
The Biden Administration’s FY 2023 proposed budget requests increased funds to enforce the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Specifically, the budget would allot $125 million to the states for MHPAEA enforcement. Additionally, President Biden requested an additional $275 million for the Department of Labor (DOL)...
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FDA Issues Final Rule Enabling Access to Over-the-Counter Hearing Aids
Around 30 million adults in the U.S. deal with some form of hearing loss, but only an estimated 1 in 5 have addressed the issue with the use of a hearing assistance device. On August 16, 2022, the U.S. Food and Drug Administration (FDA) issued a final rule that would...
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IRS Announces ACA Affordability Contribution Percentage for 2023
The IRS announced a decrease in the ACA Affordability Contribution Rate from 9.61 in 2022 to 9.12 percent for the 2023 plan year, the most significant decrease since the ACA’s commencement. Under the ACA, Applicable Large Employers (ALEs), employers with 50 or more full time and/or full-time equivalent employees, are...
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June/July 2022 Compliance Recap
The summer has seen a flurry of compliance-related activity, most notably the landmark decision issued by the U.S. Supreme Court to overturn Roe v. Wade. As we move into the second half of the 2022 employee benefits compliance calendar, there are a number of important issues to note. SCOTUS OVERTURNS ROE...
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HHS Issues Proposed Rules under ACA Section 1557 to Clarify Scope of Discrimination Protections
The U.S. Department of Health and Human Services (HHS) has announced a proposed rule (Proposed Rule) implementing Section 1557 of the Affordable Care Act (ACA) that prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in certain health programs and activities. The Proposed Rule is...
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Transparency in Coverage: Machine Readable Files
July 1, 2022, marks the effective date for plans and issuers to begin posting two Machine-Readable Files (MRF) links to a public website so individuals can readily learn their in-network group health plan costs, as well as historical paid amounts for out-of-network services. Ahead of this deadline, plans and issuers...
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Supreme Court Issues Ruling in Dialysis Case
In a 7-2 decision, the U.S. Supreme Court has issued its opinion in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., ruling in favor of Marietta Memorial Hospital’s health plan. In the Court’s opinion, drafted by Justice Brett Kavanaugh, the Court held the plan did not violate a...
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An Employer’s Guide to Workplace Protections for Abortion-Related Decisions
Employers likely have questions about abortion-related employment protections and healthcare benefits after Friday’s SCOTUS controversial decision that overturned Roe v. Wade. Given the ruling, people in states with strict abortion limitations may end up traveling to other states to receive abortion-related care. Can employees take job-protected leave to obtain such...
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May 2022 Compliance Recap
The month of May again brought relatively little major employee benefit compliance guidance from federal agencies. However, there was plenty of activity in the courts to provide useful insight into steps employer plan sponsors can take to safeguard against benefits litigation. DEPARTMENT OF LABOR PROVIDES MENTAL HEALTH CONDITION GUIDANCE UNDER...
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What Health Plan Sponsors Need to Know about Publishing Machine-Readable Files
June 1, 2022 As of July 1, 2022, group health plans must clear one of the first major compliance hurdles required by the Affordable Care Act’s (ACA) Transparency in Coverage (TiC) Final Rules. By that date, plans and insurance carriers must have prepared and posted two machine-readable files (MRFs) to...
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Temporary Flexibilities for Remote Document Examination for Form I-9 Extended
In March 2020, the Department of Homeland Security (DHS) and U.S. Immigration and Customs Enforcement (ICE) instituted a temporary policy which allowed employers with a remote workforce to defer physical presence requirements associated with Form I-9 and Section 274A of the Immigration and Nationality Act. Initially applicable only to employers...
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April 2022 Compliance Recap
After several very quiet months this year, April saw renewed compliance activity. The IRS provided guidance on transportation fringe benefits unused due to COVID-19 workplace changes and announced inflation-adjusted amounts for HSAs and HRAs. The Centers for Medicare & Medicaid Services (CMS) announced Medicare Part D rates and the parameters...
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2022 Patient-Centered Outcomes Research Institute (PCORI) Fee
The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In Notice 2022-4, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan years that end on or after October 1, 2021,...
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IRS Issues 2023 HSA and HRA Limits
The IRS issued Revenue Procedure 2022-24, to announce the 2023 inflation adjusted amounts for health savings accounts (HSAs) under Section 223 of the Internal Revenue Code (Code) and the maximum amount employers may contribute for excepted benefit health reimbursement arrangements (HRAs). Significant increases to the limits are a result of the...
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2021 EEO-1 Component 1 Data Collection Portal is Now Open
The U.S. Equal Employment Opportunity Commission (EEOC) has announced that the 2021 EEO-1 Component 1 data collection portal is now open. Eligible employers have until May 17, 2022, to submit data to the portal. The EEO-1 Component 1 report is a mandatory annual data collection that requires all private sector...
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Proposed Rule Would Fix the “Family Glitch”
Under the current Affordable Care Act (ACA) regulations, employer-based health insurance is deemed “affordable” if the employee’s contribution for self-only coverage does not exceed the affordability threshold in a given year (9.61% in 2022). Those who do not have access to affordable employer-based coverage may qualify for a premium tax...
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House Passes Secure Act 2.0 Bill
In a 414-5 bipartisan vote, the House of Representatives has passed a bill that, if enacted, is said to improve the retirement savings system in the United States by expanding coverage and increasing retirement savings. The Securing a Strong Retirement Act, colloquially known as Secure Act 2.0 builds on the...
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Temporary Flexibilities for Expired List B Identity Documents to End
In May 2020, the Department of Homeland Security (DHS) instituted a temporary policy which allowed employees to present expired List B identification documents for I-9 purposes. As a reminder, Form I-9 is used to verify the identity and employment authorization of individuals hired for employment in the United States. This...
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Government Funding Bill Extends CARES Act Relief for HDHPs
President Biden recently signed The Consolidated Appropriations Act, 2022 (CAA) into law. As part of the 2022 CAA, COVID-related telehealth coverage can be covered at no cost-share for High Deductible Health Plans (HDHPs) in a similar fashion to what was allowed under the CARES Act starting April 1, 2022 through...
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The DOL’s Compliance Assistance Release No. 2022-01 401(k) Plan Investments in “Cryptocurrencies”
As plan advisors, we’ve had increasing questions from plan sponsors and committees about the availability and merits of Crypto backed investment options. With their release last week, the DOL has made their position very clear: they will investigate plan fiduciaries who make these types of investments available, even through brokerage...
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January 2022 Compliance Recap
January brought breaking news that the U.S. Supreme Court (the Court) would stop OSHA from enforcing its employee COVID-19 test or vaccinate emergency temporary standard (ETS) for employers with 100 or more employees. Although the decision doesn’t end the OSHA ETS permanently, it means that the ETS is unlikely to...
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Departments Clarify Required Coverage of At-Home OTC COVID-19 Tests
The Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) recently issued updated FAQ guidance to explain how employer group health plans may comply with the requirement to cover with no cost-sharing or preauthorization at-home over-the-counter (OTC) COVID-19 tests provided with no prescription or health care...
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Delivery Requirements for Summary Plan Description
It’s so important for employers to understand the requirements around annual notices and annual delivery of theirs SPDs and their SBCs. There is great potential for a penalty if an employee were to request that document and not receive it within 30 days; those penalties can be up to $100...
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Supreme Court Blocks OSHA Vaccine-or-Test Mandate But Allows Vaccine Mandate for Healthcare Workers to Proceed
Oral arguments on the OSHA vaccine-or-test mandate and vaccine mandate for healthcare workers were heard on January 7, 2022. As a result, the U.S. Supreme Court has issued two opinions with different outcomes on January 13th. Both opinions are discussed in greater detail below. OSHA Vaccine-or-Test Mandate In a 6-3...
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DOL Guidance On At-Home COVID-19 Tests
The Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued Frequently Asked Questions (FAQs) Monday that generally require group health plans and insurers to cover the costs of at-home over-the-counter COVID-19 tests (OTC COVID-19 Tests) approved by the U.S. Food and Drug Administration (FDA)...
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December 2021 Compliance Recap
December was a quiet month in the compliance world in terms of large announcements, but lots of little information trickled in over the month. OSHA’s vaccine-or-test mandate for large employers and vaccine mandate for health care organizations is headed for the Supreme Court, set to be heard on January 7,...
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Vaccine Mandate for Healthcare Workers Reinstated as U.S. Supreme Court Prepares to Hear Oral Arguments on Vaccine Mandates
The Centers for Medicare and Medicaid Services (CMS) issued an emergency ruling in November 2021, which would require eligible staff at health care facilities participating in Medicare and Medicaid programs to be fully vaccinated against COVID-19. The mandate was quickly challenged in several states, resulting in a nationwide stay on...
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Sixth Circuit Lifts Stay on OSHA COVID-19 Vaccine Mandate for Employers with 100+ Employees
The U.S. Court of Appeals for the Sixth Circuit has issued an opinion lifting the stay on the vaccine-or-test mandate for employers with 100 or more employees. The stay was imposed by the Fifth Circuit Court of Appeals in November as a result of the Emergency Temporary Standard (ETS) released...
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End of Year Employee Benefits Compliance Checklist
From ACA reporting to new federal regulations, employers are faced with several obligations as they close out the year and begin to plan for 2022. To help comply with your obligations, we have complied a list of important items that apply to employer-sponsored group health plans to either review and/or...
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November 2021 Compliance Recap
November saw quite a bit of activity in the compliance space. Although OSHA’s vaccine-or-test mandate for private employers was issued, it was immediately met with resistance in the form of lawsuits and a stay from the Sixth Circuit Court of Appeals. The mandates for federal contractors and health care workers...
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IRS Proposes Permanent Extension for Distributing ACA Reports
The IRS has issued proposed regulations, which, if finalized, would extend the annual furnishing deadlines for Internal Revenue Code (IRC) Sections 6055 and 6056 reporting under the Affordable Care Act (ACA) permanently. IRC Sections 6055 and 6056 outline reporting requirements for employers and providers to confirm whether individuals have acquired...
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COVID-19 High Deductible Health Plan and IRC Section 125 Changes Expiring in 2022
Provisions in the CARES Act allowed HSA-qualified High Deductible Health Plan (HDHP) participants to receive telemedicine care on a first-dollar basis for plan years beginning on or before December 31, 2021. Additionally, the IRS issued guidance allowing HDHPs to cover the testing and treatment of COVID-19 prior to a participant...
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OSHA Suspends Emergency Temporary Standard (ETS) Vaccine Mandate
On November 17, 2021, OSHA suspended the execution and enforcement of its Emergency Temporary Standard (ETS) mandating employers with 100 or more employees to implement mandatory COVID-19 vaccination and testing policies. This suspension came after the Fifth Circuit Court of Appeals granted a motion to stay the mandate until further...
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IRS Issues 2022 FSA and Commuter Limits
The IRS has announced the 2022 max contribution limits for FSA and Commuter accounts [Revenue Procedure 2021-45]. All FSA and Commuter plans (for the 2022 plan year) will be updated with the 2022 contribution limits. If you have any questions, please contact your account team or email us at icomply@ibpllc.com....
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October 2021 Compliance Recap
October was a relatively quiet month in the compliance space. While we are still waiting for the U.S. government to release the guidance on broker compensation disclosures, here are the highlights of happenings in October. FAQs from the Departments on COVID-19 Vaccines and Employer-Sponsored Group Health Plans On October 4,...
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OSHA Issues Emergency Temporary Standard regarding COVID-19 Vaccine Mandate
On November 5, 2021, the Occupational Health and Safety Administration (OSHA) released the emergency temporary standard (ETS) requiring businesses with at least 100 employees to mandate employee vaccinations or wear masks and be tested for COVID-19 weekly. Employers subject to the vaccine mandate must begin to create a written vaccination...
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IRS Decreases Federal Affordability Percentage to 9.61% for Plan Years Beginning in 2022
IRS Decreases Federal Affordability Percentage to 9.61% for Plan Years beginning in 2022 Per the Affordable Care Act (ACA), Applicable Large Employers (ALEs), employers with 50 or more full time and/or full-time equivalent employees, are required to offer affordable minimum value coverage to all full-time employees and their dependents. To...
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Departments Issue Further Guidance Under No Surprises Act
On September 30, 2021, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), released an interim final rule (IFR) under the No Surprises Act (Act) to help protect health care consumers...
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September 2021 Compliance Recap
September saw a lot of activity in the compliance space, especially coming from the federal government. Vaccine Mandate Guidance Still Pending Vaccine mandates were on everyone’s mind, especially after Delta Airlines announced its $200 monthly surcharge and weekly testing program for unvaccinated employees. The government joined the fray when President...
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Employers COVID-19 Vaccine Resources & Kit
Sometimes it’s hard to keep up with all the latest recommendations and regulations. In an effort to ease the burden, we have compiled eight important resources that you can access when planning your COVID-19 vaccine practices. Access Here
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Biden Announces New Vaccination Executive Order
President Joe Biden took aim at vaccine resistance in America, announcing policies requiring most federal employees to get COVID-19 vaccinations and pushing large employers (100+) to have their workers inoculated or tested weekly. The below article outlines more details on these items included in the orders: OSHA is directed to...
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ARPA Subsidy Period Expiration Reminder and Updated Guidance
ARPA Subsidy Period Expiration Reminder and Updated Guidance Subsidy Period Expiration Notice ARPA requires subsidy expiration notices to be sent to Assistance Eligible Individuals (“AEIs”) prior to the expiration of the Subsidy Period. This Expiration Notice should be sent no more than 45 days and no less than 15 days...
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Departments Defer Transparency and Disclosure Rule Enforcement, Provide FAQ Guidance
Departments Defer Transparency and Disclosure Rule Enforcement, Provide FAQ Guidance On August 20, 2021, the U.S. Departments of Health and Human Services, Labor, and Treasury (collectively, the Departments), issued FAQ guidance regarding provisions of the Affordable Care Act (ACA), the No Surprises Act (the Act) and the Consolidated Appropriations Act,...
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No Surprise Billing: Interim Final Regulations Part 2
No Surprise Billing: Interim Final Regulations Part 2 On July 1, 2021, the U.S. Departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management (collectively, the Departments), issued an interim final rule (IFR) to explain provisions of the No Surprises Act (the Act) that...
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June 2021 Compliance Recap
June 2021 Compliance Recap June 2021 was not a busy month in the benefits industry, largely due to the summer vacation season and the Independence Day holiday. Importantly, however, the U.S. Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA). Additionally, the IRS unveiled a...
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The IRS Issues the Most Recent Update to Form 941
The IRS Issues the Most Recent Update to Form 941 On June 24, 2021, the Internal Revenue Service issued the most recent update to Form 941, the Employer’s Quarterly Federal Tax Return. The form has several new lines added to obtain credits for the COBRA subsidies offered under the American...
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IRS Issues Draft Form 1095-C
IRS Issues Draft Form 1095-C The Internal Revenue Service (IRS) recently issued the 2021 Draft Form 1095-C, which is required to be filed with the IRS by applicable large employers (ALEs), to report the offer of health coverage to employees. New Codes An ALE that offers an individual coverage health...
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EEOC Extends EEO-1 Deadline for 2019 and 2020 Data Submissions
EEOC Extends EEO-1 Deadline for 2019 and 2020 Data Submissions The New Deadline Gives Employers Another Month–Until August 23– To Complete Their Reports Employers now have some extra time to submit equal employment opportunity (EEO-1) workforce data from 2019 and 2020, the U.S. Equal Employment Opportunity Commission (EEOC) announced on...
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No Surprise Billing: Interim Final Regulations Part 1
No Surprise Billing: Interim Final Regulations Part 1 On July 1, 2021, the U.S. Departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management (collectively, the Departments), issued an interim final rule (IFR) to explain provisions of the No Surprises Act (the Act) that...
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EEOC Issues Updated COVID-19 Vaccination Assistance
EEOC Issues Updated COVID-19 Vaccination Assistance The Center for Disease Control (CDC) and the Equal Employment Opportunity Commission (EEOC) have issued this information related to vaccinations: Employers must be aware that certain individuals may opt to not be vaccinated, either for religious reasons or for medical reasons Under the Americans...
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Supreme Court Effectively Upholds ACA in Texas v. United States Ruling
Supreme Court Effectively Upholds ACA in Texas v. United States Ruling On June 17, 2021, the U.S. Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA) by a 7-to-2 vote. The Court heard oral arguments in the case, California v. Texas, on November 10, 2020,...
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May 2021 Compliance Recap
May 2021 Compliance Recap May 2021 was a somewhat busy month in the benefits industry. The absence of a significant of amount of agency guidance during the summer months is to be expected. However, the IRS finally issued guidance on the temporary 100% COBRA subsidy mandated by the American Plan...
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Upcoming Challenges with ACA in 2021
Upcoming Challenges with ACA in 2021 IRS Eliminates Transition Relief and Removes Threshold Expanding Eligibility In previous year, the IRS has provided relief of penalties to reporting entities that report incomplete or incorrect information as long as these entities can show they made a good-faith effort to comply with the...
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IRS Draft Form 941 Reflects COBRA Subsidy Tax Credit
IRS Draft Form 941 Reflects COBRA Subsidy Tax Credit The IRS recently released a draft of the revised 2021 version of Form 941, Employer’s Quarterly Federal Tax Return, in order to, in part, reflect the tax credit in connection with the 100% COBRA subsidy under the American Rescue Plan Act...
Read MoreFrequently Asked Questions About the Patient-Centered Outcomes/Comparative Effectiveness (PCORI Fee)
Q1: What plans does the PCORI fee apply to? A1: All plans that provide medical coverage to employees owe this fee. Medical coverage includes preferred provider (PPO) plans, health maintenance organization (HMO) plans, point-of-service (POS) plans, high deductible health plans (HDHPs), and health reimbursement arrangements (HRAs). The fee does not...
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BCBSA Antitrust Settlement Classes Eligible for Proceeds
BCBSA Antitrust Settlement Classes Eligible for Proceeds November 5, 2021 is the deadline for filing a claim in connection with the Blue Cross Blue Shield Association (BCBSA) $2.67 billion settlement reached in October 2020. The class action lawsuit was filed more than eight years ago by subscribers seeking injunctive and...
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2021 Patient-Centered Outcomes Research Institute (PCORI) Fee
2021 Patient-Centered Outcomes Research Institute (PCORI) Fee The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In Notice 2020-84, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan...
Read MoreFrequently Asked Questions About the Patient Centered Outcomes/Comparative Effectiveness (PCORI) Fee
Q1: What plans does the PCORI fee apply to? A1: All plans that provide medical coverage to employees owe this fee. Medical coverage includes preferred provider (PPO) plans, health maintenance organization (HMO) plans, point-of-service (POS) plans, high deductible health plans (HDHPs), and health reimbursement arrangements (HRAs). The fee does not...
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IRS Issues 2022 HSA and HRA Limits
IRS Issues 2022 HSA and HRA Limits The IRS issued Revenue Procedure 2021-25 on May 10, 2021, to announce the 2022 inflation adjusted amounts for health savings accounts (HSAs) under Section 223 of the Internal Revenue Code (Code) and the maximum amount that may be made newly available for excepted...
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April 2021 Compliance Recap
April 2021 Compliance Recap April was a busy month in the benefits industry, largely due to the temporary 100% COBRA subsidy mandated by the American Plan Rescue Act of 2021 (the ARP). The Departments of Labor, Treasury and Health and Human Services (the Departments) jointly issued FAQs regarding the amendments...
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The DOL Issues ARPA COBRA Subsidy Forms
The DOL Issues ARPA COBRA Subsidy Forms On April 7, 2021, the Department of Labor (DOL) issued the much awaited COBRA Model Notices required under the American Rescue Plan Act of 2021 (ARPA), implementing the 100% COBRA Subsidy for eligible individuals. In order to assist plan sponsors with implementing the...
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March 2021 Compliance Recap
March 2021 Compliance Recap The employee benefits guidance issued in March 2021 was largely focused on providing relief to individuals and businesses impacted by the continuing COVID-19 pandemic. Significantly, on March 11, 2021, the American Rescue Plan Act of 2021 (the Act) was enacted into law which, in part, mandates...
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PPE as Section 213(d) Qualified Medical Expenses
PPE as Section 213(d) Qualified Medical Expenses The Internal Revenue Service (IRS) released Announcement 2021-7 providing that amounts paid for personal protective equipment (PPE) such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of COVID-19, are qualified medical expenses under Internal Revenue Code...
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American Rescue Plan Act Brings Several Health Plan Provisions
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (Act). The Act is a $1.9 trillion legislative package that includes pandemic relief for individuals and families. The Act contains several provisions including funding to the Centers for Disease Control and Prevention, stimulus checks, unemployment benefits,...
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February 2021 Compliance Recap
February 2021 Compliance Recap February was a relatively busy month in the employee benefits world. The Department of Labor (DOL) issued EBSA Disaster Relief Notice 2021-01 regarding the end of the COVID-19 outbreak period. The Internal Revenue Service (IRS) issued Notice 2021-15 providing guidance on health flexible spending arrangements (FSAs),...
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Final Rule on the Extension of Certain Timeframes For Employee Benefit Plans, Participants, and Beneficiaries Due to COVID-19
Final Rule on the Extension of Certain Timeframes For Employee Benefit Plans, Participants, and Beneficiaries Due to COVID-19 The DOL issued EBSA Disaster Relief Notice 2021-01 providing that the outbreak period relief noted below ends on the earlier of one year from the date an individual or plan was first...
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January 2021 Compliance Recap
January 2021 Compliance Recap January was a busy month in the employee benefits world. President Biden issued a memorandum putting a regulatory freeze on new rules. President Biden also issued an executive order on strengthening Medicaid and the Patient Protection and Affordable Care Act (ACA). The Department of Labor (DOL)...
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EEOC Releases Proposed Wellness Rules under ADA and GINA
EEOC Releases Proposed Wellness Rules Under ADA and GINA The EEOC recently released proposed language revising the wellness incentive rules under the ADA and GINA. This proposed language is a revision to the rules released in 2016. Below is a summary of the proposed changes and how they may impact...
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2021 Minimum Wage Increases
2021 Minimum Wage Increases As of January 1, 2021, several US states increased their minimum wage rate. Please note, however, that some cities or municipalities may have a minimum wage rate even greater than their statewide rate. Below outlines effective wages for states where the rate will be changing. Alaska:...
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December Compliance Recap
December was a busy month in the employee benefits world. President Trump signed the Consolidated Appropriations Act, 2021, which includes the No Surprises Act and other group health plan provisions. The Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) issued two interim recommendations for COVID-19 vaccines. The Department...
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Consolidated Appropriations Act, 2021: Temporary Health FSA and DCAP Relief
Consolidated Appropriations Act, 2021 Temporary Health FSA and DCAP Relief The Consolidated Appropriations Act, 2021 (Appropriations Act), enacted on December 27, 2020, contains temporary rules to provide relief for participants in health flexible spending arrangements (FSAs) and dependent care flexible spending arrangements (DCAPs) in light of the COVID-19 pandemic. The...
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Mandatory Coverage of COVID-19 Vaccines under Group Health Plans
Mandatory Coverage of COVID-19 Vaccines Under Group Health Plans On December 11, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization for the Pfizer-BioNTech COVID-19 vaccine (Pfizer vaccine). The following day, December 12, 2020, the Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) issued an...
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Congress Passes New $1.4 Trillion Stimulus & COVID-19 Relief Bill and Awaits President’s Signature
Congress Passes New $1.4 Trillion Stimulus & COVID-19 Relief Bill and Awaits President’s Signature Details have emerged on the new $1.4 trillion omnibus spending bill which provides a $900 billion COVID-19 Stimulus package. The bill awaits President Trump’s signature and as of last night, he requested that Congress amend the...
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Blue Cross Blue Shield Association Tentative $2.67 Billion Antitrust Settlement
Blue Cross Blue Shield Association Tentative $2.67 Billion Antitrust Settlement Blue Cross Blue Shield Association (BCBSA) has recently reached a tentative $2.67 billion settlement arising out of a class action lawsuit filed more than eight years ago by subscribers seeking injunctive and compensatory relief arising out of BCBSA’s alleged violation...
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November Compliance Recap
November Compliance Recap November was a relatively busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) heard oral arguments in the case of California v. Texas, which is the case challenging the constitutionality of the ACA. The Internal Revenue Service (IRS) released the updated Patient-Centered Outcomes...
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Updated PCORI Fee Released
Updated PCORI Fee Released Employers that sponsor certain self-insured health plans are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Under the Affordable Care Act, PCORI fees were originally scheduled to apply to policy or plan years ending on or after Oct. 1, 2012 and before Oct. 1, 2019. However, in Dec....
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October Compliance Recap
October was a busy month in the employee benefits world. The Department of Health and Human Services (HHS) renewed the public health emergency due to COVID-19 which took effect on October 23, 2020. The Internal Revenue Service (IRS) issued Notice 2020-76 regarding deadline extensions and requirements for reporting of group...
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Final Rules on Coverage Transparency
Final Rules on Coverage Transparency On October 29, 2020, the Internal Revenue Service (IRS), Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, Departments), released final rules on coverage transparency, in order to provide health coverage recipients with an estimate of their potential cost-sharing liability...
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NJ Employers Must Adhere to Latest Executive Orders Mandating Health and Safety Protocols for COVID-19
NJ Employers Must Adhere to Latest Executive Orders Mandating Health and Safety Protocols for COVID-19 On October 28, 2020, New Jersey Governor Phil Murphy signed Executive Order No. 192 (EO 192), which mandates that New Jersey employers abide by certain health and safety standards in an effort to protect employees...
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IRS Announces 2021 Plan Limitations
IRS Announces 2021 Plan Limitations The IRS has recently announced the qualified plan limitations for 2021, which are determined based on annual increases in the cost of living index. Because there was only a modest increase in the index, most of the plan limits have not changed from 2020. For...
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2021 IRS Contribution Limits for FSA and Commuter Benefits
2021 IRS Contribution Limits for FSA and Commuter Benefits On Tuesday, the IRS released 2021 contribution limits for medical FSA and Commuter Benefits for 2021. There are no changes to flexible spending account (FSA) and commuter benefits contribution limits for 2021. The IRS did adjust the contribution limits for adoption...
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CARES ACT & FFCRA Tax Credits for Eligible Employers
CARES ACT & FFCRA Tax Credits for Eligible Employers Eligible employers are entitled to receive a credit in the full amount of the required sick leave and family leave, plus related health plan expenses and the employer’s share of Medicare tax on the leave, for the period of April 1,...
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3 ACA Reporting Errors and The Pandemic’s Impact
3 ACA Reporting Errors and The Pandemic’s Impact As we approach the end of 2020, we must consider how the various enrollment fluctuations due to the COVID-19 Pandemic will impact the ACA Employer Mandate and the already tedious 1095/1094 ACA Reporting. The IRS recently granted a March 2nd deadline extension...
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September Compliance Recap
September Compliance Recap September was a relatively quiet month in the employee benefits world. President Trump issued an executive order on An America-First Healthcare Plan, noting the Administration’s actions on healthcare and planned actions going forward. A federal district court halted the repeal of certain provisions of the prior final...
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Have You Received an MLR Rebate Check? What To Do Next?
Have You Received an MLR Rebate Check? What To Do Next? The Affordable Care Act requires health insurance carriers to spend at least 80-85 percent of premium dollars on medical care and healthcare quality improvement. If the carrier does not meet this medical loss ratio (MLR) obligation, it must give...
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IRS Extends ACA Reporting Deadline for Furnishing Statements for 2020 from February 1 to March 2, 2021
IRS Extends ACA Reporting Deadline for Furnishing Statements for 2020 from February 1 to March 2, 2021 As the deadline for reporting of group health coverage offered in 2020 under the Patient Protection and Affordable Care Act (ACA) approaches, the Internal Revenue Services (IRS) has issued IRS Notice 2020-76 (Notice)...
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New FAQs Address Questions Employers May Ask to Screen Employees for COVID-19 and ADA Requirements for Handling Employees’ Medical Information
New FAQs Address Questions Employers May Ask to Screen Employees for COVID-19 and ADA Requirements for Handling Employees’ Medical Information On Sept. 8, 2020, U.S. Equal Employment Opportunity Commission (EEOC) issued additional answers to frequently asked questions (FAQs) about how employers should comply with the Americans with Disabilities Act (ADA)...
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August Compliance Recap
August 2020 Compliance Recap August was a relatively busy month in the employee benefits world. The Congressional Research Service (CRS) released an updated report on health savings accounts (HSAs) that summarizes the principal rules governing HSAs and changes made to HSAs as a result of the COVID-19 pandemic. The Department...
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July Compliance Recap
July was a busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) upheld the religious exemption and moral exemption final rules to the Patient Protection and Affordable Care Act (ACA) contraceptive mandate. The Internal Revenue Service (IRS) released the indexed 2021 ACA affordability percentage. The President...
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Important Plan Considerations Regarding FSA Mid-Year Changes
Important Plan Considerations Regarding FSA Mid-Year Changes As you are aware, in order to provide additional relief to Americans during these challenging times, the IRS released Notice 2020-29 and 2020-33. These notices provided new relaxed rules for 2020 that affected Health Flexible Spending Accounts (FSAs). As a reminder if you...
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June Compliance Recap
June was a busy month in the employee benefits world. The Internal Revenue Service (IRS) released the updated patient-centered outcomes research institute (PCORI) fee amount and announced transition relief. The Department of Health and Human Services’ Office for Civil Rights (OCR) published a final rule regarding the Patient Protection and...
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PCORI Fees are Extended an Additional 10 Years
PCORI Fees are Extended an Additional 10 Years As a reminder, employers that sponsor certain self-insured health plans are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Fees for plan years that ended in 2019 are due July 31, 2020. Under the Affordable Care Act, PCORI fees were originally scheduled to apply...
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President Trump Signs Paycheck Protection Flexibility Act
President Trump Signs Paycheck Protection Flexibility Act The President authorized the Paycheck Protection Flexibility Act on June 5th after it was passed by the House on May 28th with only one dissenting vote and passed unanimously by the Senate on June 3rd. This act changes provisions surrounding loan forgiveness through...
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May Compliance Recap
May was a busy month in the employee benefits world. The Internal Revenue Service (IRS) issued IRS Notice 2020-29 that provides increased flexibility for making mid-year elections or changes under a Section 125 cafeteria plan during calendar year 2020 and provides increased flexibility to apply unused amounts in health flexible...
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Further Guidance on Internal Revenue Service Notice 2020-29
Further Guidance on Internal Revenue Service Notice 2020-29 The Internal Revenue Service (IRS) issued IRS Notice 2020-29 (Notice) that provides increased flexibility for making mid-year elections or changes under a Section 125 cafeteria plan during calendar year 2020 related to employer-sponsored health coverage, health flexible spending arrangements (health FSAs), and...
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April Compliance Recap
April was a busy month in the employee benefits world. The President signed the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA). The Department of Labor (DOL) and the Department of the Treasury (Treasury) released a final rule extending certain timeframes under the Employee Retirement Income Security Act (ERISA)...
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Final Rule on the Extension of Certain Timeframes for Employee Benefit Plans Due to COVID-19
On March 13, 2020, President Trump issued the Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak and by separate letter made a determination, under Section 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, that a national emergency exists nationwide beginning March...
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Paycheck Protection Program and Health Care Enhancement Act
Paycheck Protection Program and Health Care Enhancement Act In response to the spread of the 2019 novel coronavirus (COVID-19), President Trump signed the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA) into law on April 24, 2020. The PPPHCEA is phase 3.5 in Congress’ response to the COVID-19 pandemic...
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March Compliance Recap
March was a busy month in the employee benefits world. The President signed the Families First Coronavirus Response Act (FFCRA) into law. The Department of Labor (DOL) issued a bulletin regarding enforcement of the FFCRA. The President also signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) into...
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Gov. Murphy Signs Executive Order Granting Grace Periods for Insurance Premium Payments
Gov. Murphy Signs Executive Order Granting Grace Periods for Insurance Premium Payments On April 9, 2020, New Jersey Governor Phil Murphy signed Executive Order No. 123, extending grace periods during which certain insurance companies, including health and dental insurers, life insurers, and property and casualty insurers, will not be able to...
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CARES Act: Loans & Tax Credit Provisions
CARES Act: Loans & Tax Credit Provisions On March 27, 2020, Congress passed, and the President signed, an unprecedented 2 trillion-dollar stimulus and relief package into law, named the Coronavirus Aid, Relief, and Economic Security Act or the CARES Act. This act provides direct stimulus relief to corporations and individuals....
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CARES Act: Impact on your Retirement Plans
CARES Act: Impact on your Retirement Plans The CARES Act is the stimulus package the government recently enacted to support the country and economy during and after the coronavirus pandemic. The 880-page Act has many programs and features that affect a wide range of the economy. The points below are...
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CARES Act: Impact on Employee Benefits
CARES Act: Impact on Employee Benefits On March 27, 2020, Congress passed, and the President signed, an unprecedented 2 trillion-dollar stimulus and relief package into law, named the Coronavirus Aid, Relief, and Economic Security Act or the CARES Act. This act provides direct stimulus relief to corporations and individuals. While...
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Student Loan Relief Due to COVID-19
Overview On March 13, 2020, the U.S. Department of Education announced that it would waive interest charges, allow for suspended payments and provide assistance to borrowers of defaulted loans for 6 months. All information can be found at StudentAid.gov. Who Is Affected? All borrowers who have an outstanding federal student...
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CARES Act Provisions
On March 27, 2020, Congress passed, and the President signed, an unprecedented 2 trillion dollar stimulus and relief package into law. The law’s nearly 900 pages provide relief for specific industries, including hospitals, airlines, and railroads, as well as cash payments to individuals of up to $1,200 per adult and...
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DOL Issues Families First Coronavirus Response Act Model Notice
DOL Issues Families First Coronavirus Response Act Model Notice As required by the Families First Coronavirus Response Act, the Department of Labor has issued a model notice to be posted by employers. The notice is attached here, and should be posted or distributed to employees in its entirety. To assist...
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Families First Coronavirus Response Act
On March 18, 2020, the President signed into law the Families First Coronavirus Response Act. While largely the same as the House bill passed on March 13, the final version of the legislation differs in several material respects from the original legislation, including permitting exemptions for employers with fewer than...
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COVID-19: Leave Donation Program
Leave donation programs have been considered and implemented by employers for years to allow employees to donate accrued paid time (PTO), vacation or sick leave to a general pool. The time available in this pool serves to be used by fellow employees who have medical emergencies or who are affected...
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ACA Filings for Employers with NJ Resident Employees Due 3/31
ACA Filings for Employers with NJ Resident Employees Due 3/31 March 16th, 2020 As you may be aware, as of January 1, 2019 the State of New Jersey enacted a mandate requiring New Jersey residents to maintain Minimum Essential Health Coverage, mirroring the requirements of the federal Affordable Care Act. As...
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COVID-19 Communicating With Employees
COVID-19 Communicating with Employees March 12th, 2020 As part of their efforts to prevent the spread of COVID-19 in the workplace, employers should implement an employee communication plan about the illness to employees. The CDC, WHO and OSHA have all created informational material on the virus and its symptoms, prevention...
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Coronavirus And The Workplace
Coronavirus And The Workplace March 12th, 2020 Dealing with Epidemics and Communicable or Infectious Diseases As the number of reported cases of the novel Coronavirus (COVID-19) continues to rise, employers are increasingly confronted with the possibility of an outbreak in the workplace. Employers are obligated to maintain a safe and...
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February 2020 Compliance Recap
February was a busy month in the employee benefits world. The Centers for Medicare and Medicaid Services (CMS) released an updated Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) model notice. CMS also issued frequently asked questions (FAQs) regarding its recently issued summary of benefits and coverage...
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January 2020 Compliance Recap
January was a busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) denied expedited review of a court case challenging the constitutionality of the Patient Protection and Affordable Care Act (ACA). The Supreme Court also granted review of a nationwide preliminary injunction of the November 2018...
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DOL Increases ERISA Penalties for 2020
January 29th, 2020 On January 15, 2020, consistent with its policy of annual adjustment, the DOL published its final rule adjusting ERISA’s civil monetary penalties for 2020. ERISA protects the interests of employee benefit plan participants and their beneficiaries. The adjustments are non-discretionary (and therefore not subject to a notice...
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December Compliance Recap
December was a busy month in the employee benefits world. The U.S. Court of Appeals for the Fifth Circuit held that the Patient Protection and Affordable Care Act’s (ACA’s) individual mandate is unconstitutional. The Internal Revenue Service (IRS) released final instructions and final 1094-B, 1095-B, 1094-C, and 1095-C forms for...
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The NJ Commuter Benefit Law Coming March 2020
The NJ Commuter Benefit Law Coming March 2020 January 10th, 2020 The new year comes with many changes for employers, but it doesn’t just stop after January. With the world constantly changing around us, so are the laws that we must follow. As of March 1st, the New Jersey Commuter...
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The 2020 Leap Year Impacting Payroll
The 2020 Leap Year Impacting Payroll January 9th, 2020 As always, the new year comes with a great deal of changes. With 2020 being a leap year, some of these changes may even be overlooked. A leap year typically occurs every four years, adding one extra day to the month...
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Four Laws That Went into Effect 1/1/2020
There were several notable laws that effect employers beginning 1/1/2020. It is important for employers to understand how these laws effect your employees and business and any necessary next steps you need to take. As always, your Innovative team will help you understand how these changes will affect your plans...
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The ACA’s Cadillac, HIT and Medical Device Taxes Are Repealed; PCORI Fee Extended for 10 More Years
On December 20, 2019, the President signed a $1.4 trillion spending bill that will fund the federal government through September 30, 2020. The bill signed by the President specifically includes the repeal of three major taxes that fund the Affordable Care Act (ACA), including the “Cadillac” tax, the health insurance...
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November Compliance Recap
November was a busy month in the employee benefits world. The Internal Revenue Service (IRS) released draft 2019 instructions for Forms 1094-B, 1095-B, 1094-C, and 1095-C. The IRS also released health plan limits and various compensation, benefit, and contribution levels under qualified retirement plans for 2020. The Department of Health...
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IRS Extends ACA Reporting Deadline for Furnishing Statements for 2019 from January 31 to March 2, 2020
In Notice 2019-63, the IRS extended the 2020 deadline for employers and insurers to furnish individual statements on 2019 health coverage and full-time employee status (Forms 1095-B and 1095-C) from January 31 to March 2. The notice also extends the good-faith penalty relief to 2019 for incorrect or incomplete reports due in 2020....
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Innovative Welcomes Lisa as Director of Compliance
We are excited to announce the latest addition to the Innovative Benefit Planning team! Please join us in welcoming Lisa A. Hill as our Director of Compliance. As Director of Compliance, Lisa will be a valuable resource to Innovative’s leadership team, employees, and clients in ensuring all compliance needs are...
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2020 IRS Contribution Limits Released
On Wednesday, the IRS announced new contribution limits for medical FSA, Commuter Benefit, and HSA plans for 2020. The FSA contribution will increase to $2,750, a $50 increase from current limits. The HSA contribution limit for individuals with a high deductible health plan (HDHP) will likewise be raised from $3,500...
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September 2019 Compliance Recap
September was a busy month in the employee benefits world. The U.S. Senate confirmed Eugene Scalia as the new Secretary of the Department of Labor (DOL). The Internal Revenue Service (IRS) published proposed rules regarding affordability safe harbors and Section 105(h) nondiscrimination rules as applied to individual coverage health reimbursement...
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DOL Overtime Rule Change
On Sept 24th, the US Department of Labor (DOL) released a new rule, increasing the minimum salary level for exempt status to $35,568 per year for a full-time employee, effective January 1, 2020. Read the full law, here: DOL Overtime Rule Change The proposed rule creates the...
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August 2019 Compliance Recap
August was a relatively quiet month in the employee benefits world. The Department of Labor (DOL) issued its updated Medicaid / CHIP Model Notice. The Centers for Medicare and Medicaid Services (CMS) revised its Medicare Secondary Payer User Guide and changed reporting requirements regarding prescription drug coverage beginning January 1,...
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NJ Bans Salary History
On July 25th, 2019, New Jersey’s Acting Governor Sheila Oliver signed NJ Bill A1094 (“the Law”), which bans employers from asking applicants for their salary history. Read the full law here, NJ Bans Salary History, to learn: What is now illegal for an employer to do What the law allows...
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July 2019 Compliance Recap
July was a busy month in the employee benefits world. The Internal Revenue Service (IRS) released a notice that expands the list of preventive care benefits a high deductible health plan can provide without a deductible or with a deductible below the annual minimum deductible. The IRS also released the...
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Additional Preventive Care Benefits Permitted for High Deductible Plans
In Executive Order 13877, issued June 2019, the Treasury Department and the IRS were directed to consider ways to expand the use and flexibility of HSA’s and HDHP’s. In response to the Executive Order, the Treasury Department issued guidance on July 17, 2019, that lists newly identified preventive care items...
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Pennsylvania Medical Marijuana Updates
Effective July 20, 2019, Pennsylvania will recognize anxiety and Tourette Syndrome as serious medical conditions in the medical marijuana program. The Pennsylvania Department of Health stated that the decision came after a research-based recommendation by the state’s Medical Marijuana Advisory Board, followed by Health Secretary Rachel Levine ’s careful review of the...
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HRA Final Rules
The Department of the Treasury (Treasury), Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively, the Departments) recently released their final rules regarding health reimbursement arrangements (HRAs) and other account-based group health plans. An HRA is a type of account-based group health plan funded solely by...
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EEOC Component 2 Data Update
On July 2, 2019, following initial notifications to employers of the upcoming Component 2 filing deadline, the EEOC updated the Component 2 website to include both Additional Information https://eeoccomp2.norc.org/info.html and Frequently Asked Questions (FAQs) sections. https://eeoccomp2.norc.org/faq.html Under the Additional Information section, employers can find a sample form, an instruction booklet,...
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NJ Now Has Greater Protections for Employees Who Are Cannabis Users
On July 2, 2019, New Jersey Governor Phil Murphy signed a bill into effect that overhauls the state’s existing medical cannabis program and law, the Compassionate Use of Medical Marijuana Act (CUMMA), and greatly expands patient access to medical marijuana. For employers who must address the issue of employees and...
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June 2019 Compliance Recap
June was a relatively busy month in the employee benefits world. The Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Department of Treasury published final rules that removed the prohibition against integrating a health reimbursement arrangement (HRA) with individual health insurance coverage and recognized certain...
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Compliance Alert: IRS Raises HSA/HDHP Limits for 2020
Compliance Alert: IRS Raises HSA/HDHP limits for 2020 The IRS has announced that effective January 1, 2020, an individual in a High Deductible Health Plan (“HDHP”) with self-only coverage has a new maximum allowable annual contribution into a Health Savings Account of $3,550 , increased from $3,500. The maximum annual...
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New NJ Commuter Law
Governor Murphy signed a new law on March 1, 2019, read here: Commuter Law, requiring certain employers to provide pre-tax commuter fringe benefits to employees. New Jersey employers with at least 20 employees in the state will need to begin offering those employees pre-tax transportation fringe benefits covering commuter highway vehicle...
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March 2019 Compliance Recap
March was a busy month in the employee benefits world. The Department of Justice (DOJ) announced that it will not defend the Patient Protection and Affordable Care Act (ACA) in the court case challenging the ACA’s constitutionality. The Internal Revenue Service (IRS) updated two Q&As regarding ACA reporting for 2018....
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February 2019 Compliance Recap
February was a quiet month in the employee benefits world. The Internal Revenue Service (IRS) released an information letter addressing when an employer may seek recoupment of contributions made to an employee’s HSA. A U.S. District Court held that the State of Maryland could not ask for a declaration that...
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Recent Updates in New Jersey Law
A lot has been happening in New Jersey since the new year began, and there have been a few critical updates for New Jersey employers and employees. New Jersey Minimum Wage On January 17, 2019, Governor Phil Murphy and legislative leaders agreed on legislation that will incrementally increase New Jersey’s...
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January 2019 Compliance Recap
January was a relatively quiet month in the employee benefits world. The Department of Labor (DOL) issued its annual adjustment of federal civil monetary penalties. The Centers for Medicare & Medicaid Services released a proposed rule for benefit payment and parameters for 2020. The Internal Revenue Service (IRS) released its...
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December Compliance Recap
December was a relatively quiet month in the employee benefits world. A U.S. District Court issued an order declaring that the Patient Protection and Affordable Care Act (ACA) is unconstitutional. The Equal Employment Opportunity Commission (EEOC) issued two final rules to remove certain wellness program incentives. The Department of Labor...
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November Compliance Recap
November was a busy month in the employee benefits world. The Internal Revenue Service (IRS) extended the due date for employers to furnish Forms 1095-C or 1095-B to individuals, extended “good faith compliance efforts” relief for 2018, and issued specifications for employer-provided substitute ACA forms. The Department of the Treasury...
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NJ Consumer Protection Act goes into effect on August 29, 2018
On August 29th, 2018, the “Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act” will go into effect. All fully-insured health plans must follow the New Jersey state mandate, while self-funded health plans can decide to opt-in. Innovative Benefit Planning has prepared a brief on what employers should know about...
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Trump Administration Suspends Billions in Risk Adjustment Payments to Insurers
Background The implementation of the Affordable Care Act brought uncertainty to many insurers. To guard against adverse selection, and the threat of insurer insolvencies, the federal government enacted safety measures to stabilize the individual markets. The “3 R’s of Health Insurance” sought to balance the risk pool by eliminating uncertainty...
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Innovative Heads to Capitol Hill
Earlier this week Dan Foley, Ryan Kastner & Yesenia Perez from the Innovative team headed to Washington D.C. for the NAHU 2018 Capitol Conference. During their time in Washington, the trio attended a number of informative sessions that detailed changing legislation that directly impacts the health insurance market and engaged...
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December Compliance Recap
December was a relatively busy month in the employee benefits world. The Internal Revenue Service (IRS) delayed the reporting deadlines in 2018 for the 1095-B and 1095-C forms to individuals. President Trump signed the Tax Cuts and Jobs Act. The Centers for Medicare and Medicaid Services (CMS) released guidance on...
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