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The Health Insurance Portability and Accountability Act (HIPAA) requires health plans to provide special enrollment opportunities for employees and their dependents outside the plans’ regular enrollment periods in certain situations. Employees and dependents may have special enrollment rights when an individual: Loses eligibility for other health coverage; Becomes a new dependent through marriage, birth, adoption
HSA/HDHP Limits Will Increase for 2024 On May 16, 2023, the IRS released Revenue Procedure 2023-23 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2024. The IRS is required to publish these limits by June 1 of each year. These limits include: The maximum HSA contribution
High deductible health plans (HDHPs) are becoming a popular health plan offering among employers nationwide. HDHPs can encourage employees to spend their health dollars wisely and can motivate them to take charge of their own health and wellness. To maximize the odds that your HDHP will be a success, avoid making these five common mistakes.
Report Finds Compliance With Health Care Price Transparency Rules Is on the Rise A recent report from health care price transparency startup Turquoise Health found that the current state of payer and hospital price transparency is evolving beyond reluctant acceptance. The startup’s second Price Transparency Impact Report attributed this shift to the compliance of more
IRS Releases FAQs on Medical Expenses Related to General Health Nutrition and Wellness Highlights The IRS released FAQs that focus on when costs related to general health, nutrition and wellness can be paid or reimbursed by an HSA, health FSA or HRA. Some expenses are always eligible, such as those for dental and eye exams.
Beginning in 2023, group health plans and health insurance issuers must make an internet-based price comparison tool available to participants, beneficiaries and enrollees. The purpose of this tool is to provide consumers with real-time estimates of their cost-sharing liability from different providers for covered items and services, including prescription drugs, so they can shop and
On Nov. 28, 2022, the Department of Health and Human Services (HHS) released proposed changes to its rules regarding the confidentiality of substance use disorder (SUD) treatment records. These confidentiality rules are contained in 42 CFR Part 2 and are commonly referred to as “Part 2.” Part 2 protects the confidentiality of patient records from
Panel Releases Recommendation for Anxiety Screening in Adults On Sept. 20, 2022, the U.S. Preventive Services Task Force (PSTF) released a draft recommendation for anxiety screening in adults younger than age 65. This follows the PSTF’s draft recommendation from April 12, 2022, which endorsed anxiety screening in children ages 8 to 18. These recommendations highlight
On Aug. 16, 2022, President Joe Biden signed the Inflation Reduction Act into law. While this law is primarily aimed at fighting inflation and reducing carbon emissions, it also contains a number of reforms that will impact health coverage. The health reforms included in the law have staggered effective dates and will be implemented over
On April 29, 2022, the IRS released Revenue Procedure 2022-24 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2023. The IRS is required to publish these limits by June 1 of each year. These limits include: The maximum HSA contribution limit; The minimum deductible amount for
To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2022. Employers should review their plan documents to confirm that they include these required changes. In addition, any changes to a health
What Is the Delta Variant? As the country reopens, a surge in COVID-19 cases has occurred. According to the Centers for Disease Control data, this surge is primarily due to the Delta variant of COVID-19; it currently accounts for over 80% of new COVID-19 cases across the country, according to U.S. News. The Delta variant
Industry trends, protocols and in-demand skills are always changing. Especially in today’s job market, employers can remain competitive by prioritizing employee learning and development (L&D) efforts. Why It Matters Employee retention rates increase by between 30% and 50% for companies with strong learning cultures. In addition, L&D opportunities can increase overall morale due to increased
Transcript: Legal Update: COVID-19 Exchange Special Enrollment Period Extended On March 23, 2021, CMS extended a special enrollment period (SEP) through federal Exchanges due to the COVID-19 pandemic for an additional three months. This SEP is now available through Aug. 15/ 2021, via www.HealthCare.gov to all new and existing Echange-eligible consumers. States using their own
On Dec. 27, 2020, President Trump signed the Consolidated Appropriations Act, 2021 into law. The Act includes a $900 billion coronavirus relief package that provides funding for unemployment benefits, direct economic payments to individuals, vaccine distribution and rental assistance. It also includes the No Surprises Act, a ban on surprise medical bills, which takes effect
Employer Tax Credit for Paid Family and Medical Leave Pursuant to § 45S of the Internal Revenue Code (Code), employers that provide paid family and medical leave to their workers may qualify for a general business credit. The tax credit is a percentage of wages paid between January 1, 2018 and December 31, 2019 only.
Wilmer One of Twenty Women Presented by “Employee Benefits Adviser” Magazine during Annual Workplace Benefits Summit
Grandfathered health plans are exempt from certain requirements under the Affordable Care Act (ACA). A plan loses its grandfathered plan status if it makes certain changes to reduce its benefits or increase the participant’s out-of-pocket costs. Quick Facts: A group health plan is grandfathered if it was in existence as of March 23, 2010 and
The deadline for contributing entities to submit their 2014 annual enrollment counts has been extended until 11:59 p.m. on Dec. 5, 2014. Download the Article Quick Facts The reinsurance fee annual enrollment count must be submitted by Nov. 15 each year. On Nov. 14, 2014, CMS extended the regulatory deadline for 2014 to 11:59 p.m.
The Affordable Care Act’s “employer shared responsibility” provision – often referred to as the “employer mandate” or “play or pay” – applies only to employers with 50 or more full-time-equivalent employees. Starting in 2015, a Large Employer may be assessed a penalty for failure to offer health care coverage to its full-time employees. No penalties
Employer’s Role in Mental Health Care In March, Germanwings Flight 9525 crashed in the French Alps, killing all 150 passengers and crew members on board. Investigators later determined that the crash was deliberately cased by co-pilot Andreas Lubitz, who had a history of depression, reportedly exhibited suicidal tendencies and contacted a number of doctors for
With respect to employer-sponsored group health coverage, the majority of requirements under the Affordable Care Act impact the insurance carrier that issues the group contract. Thus, the carrier takes the required actions while the employer does not have direct actions. Examples of items taking effect 2010-2013 that require/required carrier action include: expanding child eligibility though
Plan sponsors of group health plans offering prescription drug coverage to Medicare eligible individuals have been responsible for issuing notices to Medicare Part D eligible individuals for several years now. The annual notice deadline is before October 15 of each year. The following explains the employer notice requirements. The Medicare Modernization Act (MMA) requires employers
Only if the employer offers a self-funded plan. In that case the employer would complete forms 1094-B and 1095-B. Otherwise, only applicable large employers (ALEs) are required to complete forms 1094-C and 1095-C. ALEs are those who had an average of 50 full-time employees (including FTEs) in the previous calendar year.
Minimum essential coverage (MEC) means and includes the following types of health care coverage: Employer-sponsored coverage (including self-funded [self-insured] plans, COBRA coverage and retiree coverage) Coverage purchased in the individual market, including a qualified health plan offered by the Healt Insurance Marketplace Medicare Part A coverage and Medicare Advantage plans Most Medicaid coverage Children’s Health
