Benefits Buzz

Posted November 8th, 2023 in Employers, Producers, Individuals

The Employee Retirement Income Security Act of 1974 (ERISA) requires plan sponsors of health and welfare benefit plans (e.g., medical, dental, vision, HRA, FSA) to provide a Summary Plan Description (SPD) to plan participants at certain times. An SPD is a written document that summarizes the material provisions of a plan and describes how the plan operates.

Posted October 31st, 2023 in Employers, Producers

The Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices. PCORI is funded in part by fees which are charged to health plans. The following information is designed to help employers understand their upcoming payment obligations.

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Posted October 18th, 2023 in Employers, Producers, Individuals

The House Ways and Means Committee recently cleared legislation which would make substantial enhancements and improvements to Health Savings Accounts (HSAs). There are two bills which have now been cleared for a vote in the House of Representatives (House). If passed in the House, the bills would then need to be approved by the Senate before going to the president for signature.
 

Posted October 2nd, 2023 in Employers, Producers
Each year employers must provide a written notice to Medicare-eligible employees who are covered under their group health plan. The notice must include information about the creditable coverage status of the prescription drug benefit. In other words, the notice tells employees if the prescription drug benefit on the group health plan is at least as good as the standard Medicare Part D plan.
 
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Posted September 27th, 2023 in Employers, Producers

Employers often wonder if they can pay or reimburse employees for Medicare premiums if they waive coverage under the employer-sponsored group health plan. This may drive down the overall cost to the employer, and it may even be in the best interest of some Medicare-eligible participants; however, this type of action is generally prohibited under various laws.

Posted September 20th, 2023 in Employers, Producers

The Employer Mandate guidelines state that coverage is affordable when an employee must pay no more than 9.5% of their household income (inflation-adjusted to 8.39% for the 2024 plan year) for self-only coverage which is offered, but which employers know the household income of an employee?

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