Benefits Buzz
The Employee Retirement Income Security Act of 1974 (ERISA) requires employers to provide a Summary Plan Description (SPD) to employees if they offer health, dental, vision, life, disability, or other benefits.
The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) jointly issued guidance on a new requirement that individual and group health plans must cover over-the-counter (OTC) COVID-19 diagnostic tests.
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.
The Consolidated Appropriations Act of 2021 included a provision that requires brokers and consultants to disclose all direct and indirect compensation they expect to receive for group health plans. The disclosure is required when compensation is expected to be $1,000 or more, and the disclosure must be made prior to any contracts entered into, renewed, or extended on or after December 27, 2021. The disclosure requirements are now in effect.
Annual Medicare Part D reporting is required for all employers who provide health benefits with prescription drug coverage. The reporting is an online filing to the Centers for Medicare & Medicaid Services (CMS), and it lets CMS know if the prescription drug coverage available on the employer’s health plan is “creditable.”
