Employee Benefits

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.  
 
Posted June 19th, 2015 in Producers, Employers, Individuals

What happens to Health and Dependent Care FSAs when a merger or acquisition occurs?  

 
Of course the Cafeteria Plan regulations do not specify how this should be treated, but the IRS has provided some guidance in the form of Revenue Ruling 2002-32. Fortunately, for employees, the IRS has taken a position that employees should not be punished as a result of a merger or acquisition, and the guidance suggests two possible options that would be acceptable in their eyes. Both options maintain the salary reduction of the employee and preserve the annual election.
Posted May 15th, 2015 in Producers, Employers
The third installment of the Patient-Centered Outcomes Research Institute (PCORI) fees will be due on July 31, 2015. As its name suggests, PCORI is a research institute, and it was created by the Affordable Care Act (ACA) as a way to improve clinical effectiveness. It is partially funded by fees charged to health plans. Here is information and some reminders about the upcoming fee that is due.
 
  • The fee is paid on the average number of covered lives for the plan year ending in 2014.

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