Employee Benefits

Posted August 15th, 2016 in Producers, Employers
If you are an employer who offers a group health plan to employees who reside in the following states, then the Department of Labor (DOL) requires you to provide a premium assistance notice to employees who are eligible for the group health plan and who are also eligible (or may become eligible) for Medicaid, including the employees children who are also eligible (or may become eligible) for the Children’s Health Insurance Program (CHIP): 
 
Posted May 10th, 2016 in Producers, Employers
What happens to beneficiaries who are enrolled in COBRA when a merger or acquisition occurs?
 
The Internal Revenue Service (IRS) has some rather thorough and complex guidelines that address COBRA issues when business reorganizations occur, including mergers and acquisitions. In an effort to simplify an otherwise complex situation, we can generally break down the guidance as follows:
 
Posted April 11th, 2016 in Producers, Employers
Originally posted on January 2, 2015 and updated on April 10, 2015, June 19, 2015 and April 11, 2016.
 
Posted February 19th, 2016 in Producers, Employers

Premium Only Plans (POP) can generally be defined as a type of Cafeteria Plan where the only pre-tax benefit available to employees are for those of insurance premiums. Now, whenever non-taxable benefits are involved, the IRS will usually have some strict rules in place that must be followed. For Cafeteria Plans, these are referred to as non-discrimination rules, and these rules are in place to ensure the plan doesn’t discriminate in favor of highly compensated and/or key employees.

Posted January 22nd, 2016 in Producers, Employers
The Employee Retirement Income Security Act of 1974 (ERISA) requires most employers, who offer health and welfare benefits, to provide a written plan document to participants. The plan documents that are issued by insurance companies and other benefits providers are typically standardized and don’t include all of the customized, employer-specific language that the ERISA law requires.
 
Posted October 23rd, 2015 in Producers, Employers

The Protecting Affordable Coverage for Employees (PACE) Act, signed into law by President Obama on October 7, 2015 gives states the ability to continue to determine the size of their small group market rather than conforming to a national standard.

Most states currently define their small group market as employers with up to 50 employees, but the Affordable Care Act (ACA) was set to expand that definition in 2016 to include employers with up to 100 employees. The PACE Act allows each state to independently decide what small group market definition makes the most sense.

Posted October 14th, 2015 in Producers, Employers

The 2016 Medicare Part D annual enrollment period will begin on October 15, 2015 and run through December 7, 2015. Medicare beneficiaries can enroll in a Part D drug plan or make changes to existing coverage during this time period. Enrollment can be done through a stand-alone drug plan or a Medicare Advantage plan that integrates coverage for medical and drug expenses.      

Posted July 17th, 2015 in Producers, Employers
All eyes are back on the Employer Mandate as expectations of major changes or delays to this provision are quickly fading in light of the King vs. Burwell ruling.
Posted July 10th, 2015 in Producers, Employers
On June 26, 2015, the Supreme Court of the United States (SCOTUS) provided a ruling on same-sex marriage which is impactful to the health insurance industry. In a 5-4 ruling, the court determined that all states in the country must issue marriage certificates to same-sex couples, and states must also recognize same-sex marriages that are performed in other states.  
 

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