Benefits Buzz
The Consolidated Appropriations Act of 2021 included a provision that prohibits group health plans and health insurance carriers from entering into agreements with a health care provider, network or association of providers, third-party administrator (TPA), or other service provider offering access to a network of providers that would directly or indirectly restrict a plan or issuer from:
“Mini-COBRA” is a term commonly used for states that have passed a law to require continuation of coverage rights for group insurance plans that are regulated by the state. Most commonly, Mini-COBRA applies to fully insured medical plans and Health Maintenance Organizations (HMOs). A handful of states also extend continuation of coverage rights to fully insured dental and/or vision plans, and one state (Minnesota) extends continuation of coverage rights to group term life insurance.
The Internal Revenue Service (IRS) requires employers who sponsor a Cafeteria Plan (sometimes called a Section 125 Plan or Premium-only-Plan) to conduct certain non-discrimination tests. Because a Cafeteria Plan provides tax-free benefits, the IRS has rules in place so that tax-free benefits are not provided or elected more favorably to employees who are considered key employees. This is referred to as the Key Employee Concentration Non-Discrimination Test.
Cafeteria Plans, sometimes called Premium-only-Plans (POPs) or Section 125 Plans, allow employees to pay for health and welfare benefits with pre-tax contributions. Because contributions are tax-deductible, the Internal Revenue Service (IRS) has a set of rules in place to ensure highly compensated employees are not receiving or electing benefits more favorably than non-highly compensated employees. This is referred to as the Contributions and Benefits Non-Discrimination Test.
Cafeteria Plans, sometimes called Premium-only-Plans (POPs) or Section 125 Plans, allow employees to pay for health and welfare benefits with pre-tax contributions. Because contributions are tax-deductible, the Internal Revenue Service (IRS) has a set of rules in place to ensure highly compensated employees are not eligible for benefits more favorably than non-highly compensated employees. This is referred to as the Eligibility Non-Discrimination Test.
Shortly after the COVID-19 national emergency was declared in 2020, the Department of Labor (DOL) issued guidance allowing for additional time for participants to make COBRA elections and premium payments and to exercise their HIPAA special enrollment rights, among other things. Employers, administrators, and insurers are to disregard a period of time referred to as the “Outbreak Period.” The Outbreak Period will end 60 days after the COVID-19 national emergency ends.
