Employers

Posted December 6th, 2023 in Employers, Employees

The reporting requirements of the Affordable Care Act (ACA) are quickly approaching. Employers subject to the Employer Mandate should prepare to submit Forms 1094-C/1095-C to the Internal Revenue Service (IRS) by April 1, 2024. Employers not subject to the Employer Mandate but who offer a self-funded plan, including level funded plans and Individual Coverage Health Reimbursement Arrangements (ICHRAs) should be prepared to submit Forms 1094-B/1095-B to the IRS by this same date.

Posted November 29th, 2023 in Employers, Producers

There is a new annual compliance requirement that applies to “plans” and “issuers.” For the avoidance of doubt, the term plan means employer and the term issuer means health insurance carrier.

Each year, employers and health insurance carriers must submit a gag clause prohibition compliance attestation. This will be due by December 31st of each year with the first attestation due by December 31, 2023. So, what does this really mean?

Posted November 13th, 2023 in Employers, Employees, Producers

The Internal Revenue Service (IRS) published Revenue Procedure 2023-34 on November 9, 2023. The Revenue Procedure includes the inflation-adjusted 2024 contribution limits for certain employee benefit programs. Below is a summary of some of those contribution limit adjustments.

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?

Posted September 5th, 2023 in Employers, Producers, Individuals

Under guidance issued in 2020, qualified High Deductible Health Plans (HDHPs) have been permitted to cover COVID-19 testing and treatment prior to the deductible and without it impacting the eligibility for a person to make contributions to a Health Savings Account (HSA). The Internal Revenue Service (IRS) has recently indicated this temporary provision will be coming to an end.

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