Federal Requirements for Fully Insured and Self-Funded Plans

Posted by Matt Schwartz on Wed, Jan 15, 2020 @ 08:01 AM

Updated January 2020

A plan sponsor’s requirements under federal law will vary depending on factors such as group health plan design, size, grandfathered status, and whether the plan is fully insured or self-funded.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - December 2019

Posted by Matt Schwartz on Thu, Jan 9, 2020 @ 08:01 AM

Compliance Recap

December 2019

 

December was a busy month in the employee benefits world.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - November 2019

Posted by Matt Schwartz on Thu, Dec 12, 2019 @ 08:12 AM

November was a busy month in the employee benefits world.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Frequently Asked Questions about Grandfathered Plans - Updated

Posted by Matt Schwartz on Tue, Nov 26, 2019 @ 09:11 AM

As employers determine their plan designs for the coming year, those with grandfathered status need to decide if maintaining grandfathered status is their best option. The following are some frequently asked questions and answers about grandfathering a group health plan.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Update on Nondiscrimination Regulations Relating to Sex, Gender, Age and More

Posted by Matt Schwartz on Thu, Nov 14, 2019 @ 11:11 AM

The Patient Protection and Affordable Care Act (ACA) Section 1557 provides that individuals shall not be excluded from participation in, denied the benefits of, or be subjected to discrimination under any health program or activity which receives federal financial assistance from the Department of Health and Human Services (HHS), on the basis of race, color, national origin, sex, age, or disability.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - October 2019

Posted by Matt Schwartz on Thu, Nov 7, 2019 @ 08:11 AM

October was a relatively quiet month in the employee benefits world.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Play or Pay Penalty and Counting Employees - Updated

Posted by Matt Schwartz on Mon, Oct 28, 2019 @ 08:10 AM

Beginning in 2015, to comply with the Patient Protection and Affordable Care Act (ACA) “large” employers must offer their full-time employees health coverage, or pay one of two employer-shared responsibility/ play or pay penalties.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Tri-Agency Final Rules on Health Reimbursement Arrangements - Updated

Posted by Matt Schwartz on Mon, Oct 14, 2019 @ 08:10 AM

On September 30, 2019, the Internal Revenue Service (IRS) published its proposed rules to clarify how the employer shared responsibility provisions and Section 105(h) nondiscrimination rules apply to health reimbursement arrangements (HRAs) and other account-based group health plans that are integrated with individual health insurance coverage or Medicare.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Final FAQs, Model Disclosure Form, and Enforcement Fact Sheet Regarding Mental Health and Substance Use Disorder Parity

Posted by Matt Schwartz on Fri, Oct 11, 2019 @ 11:10 AM

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the “Departments”) released final FAQs About Mental Health and Substance Use Disorder Parity Implementation and the 21st Century Cures Act Part 39.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - September 2019

Posted by Matt Schwartz on Fri, Oct 4, 2019 @ 10:10 AM

 

September was a busy month in the employee benefits world.

The U.S. Senate confirmed Eugene Scalia as the new Secretary of the Department of Labor (DOL).

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits