by Amy M. Gordon, Jamie A. Weyeneth and Megan Mardy
Recently issued Affordable Care Act guidance clarifies the prohibition on waiting periods in excess of 90 days and eliminates the requirement to issue HIPAA group health plan certificates of creditable coverage after December 31, 2014.
To read the full article, click here.
by Stephen D. Erf, Heather Egan Sussman and Sabrina E. Dunlap
The U.S. Department of Labor recently issued a final rule implementing new expanded rights for families of military members and veterans, and greater access to Family and Medical Leave Act (FMLA) leave for airline flight crews. Companies should review and update their FMLA policies to account for this new rule.
To read the full article, click here.
by Amy M. Gordon and Jamie A. Weyeneth
Final HIPAA privacy and security regulations issued by the U.S. Department of Health and Human services will require action by group health plan sponsors by September 2013.
To read the full article, click here.
by Amy M. Gordon, Susan M. Nash and Jacob Mattinson
As part of the Patient Protection and Affordable Care Act, the U.S. Department of Health and Human Services (HHS) recently released final regulations regarding the transitional reinsurance program fee effective in CY 2014. Effective May 10, 2013, the regulations address the estimated amount of annual contributions that will be paid to HHS from employer-sponsored group health plans, the types of welfare plans that are subject to the fee, the applicability of the fee to COBRA coverage and the treatment of certain retiree benefits.
To read the full article, click here.
by Amy M. Gordon, Anne W. Hance and Susan M. Nash
The U.S. Department of Health and Human Services (HHS) Essential Health Benefits Final Rule and actuarial value regulations offer few surprises and much needed certainty to enable group health plans and health insurance issuers to move forward with designing their essential health benefits packages for the 2014 benefit year.
To read the full article, click here.
by Susan M. Nash, Mary K. Samsa and Maggie McTigue
The U.S. Department of Labor (DOL) audits already evaluate a company’s compliance on a spectrum of laws, statutes and regulations. However, the DOL has updated and revamped its audit letter to now also capture compliance aspects of the Patient Protection and Affordance Care Act. Not only is the DOL looking for certain compliance information on health plans, but also for the various records and documents related to the plan.
To read the full article, click here.
by Anne W. Hance and Amy M. Gordon
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) released on January 30, 2013, two proposed rules and a final rule relating to the Affordable Care Act’s (ACA) requirement that individuals maintain “minimum essential coverage” (MEC) or be subject to a “shared responsibility” payment.
Next Steps
Health insurance issuers will want to consider whether the various products they offer or administer will meet the MEC requirements set forth in HHS’s proposed rule, in order to respond to inquiries from customers, to meet notice requirements (including inserting model statements into existing plan documents, as applicable), and potentially to respond to exchanges making eligibility determinations. If a product does not constitute MEC, issuers may want to consider whether to continue to offer the product in its current form or revise the coverage to meet the MEC requirements.
Sponsors of group health plans will need to consider the separate affordability standards for employees and for related individuals and the implications for group health plan participants, and either modify coverage to meet the MEC standards, or consider the consequences of the shared responsibility payment.
by Amy M. Gordon and Susan M. Nash
The U.S. Department of Labor (DOL) pushed back the deadline for employers to notify their workers that they can purchase medical benefits on health insurance exchanges. The original deadline was March 1, 2013, and has now been moved to late summer or early fall 2013. The DOL said it was aiming for a “smooth implementation process” that would balance the need to give employers sufficient time to comply with the desire that notices be distributed closer to the October 1, 2013 start of exchange enrollment.
In its announcement, the DOL said it might provide “generic language” that employers could distribute to satisfy the notice requirement. Alternatively, the DOL said it might allow use of a template that was discussed in the proposed rules published in the Federal Register (See Volume 78, Number 14, Tuesday, January 22, 2013).
The notices are required to have three components:
We will keep you updated as further guidance is released.
by Amy M. Gordon and Susan M. Nash
As you are probably aware, Congress has passed and President Obama has signed the American Taxpayer Relief Act of 2012 (ATRA), which avoided the “fiscal cliff.” This newsletter outlines what that means for your employer-provided fringe benefit plans.
Qualified Transportation Plans
ATRA extends through the end of 2013 the transit parity rule that makes the combined monthly limit for qualified transit pass and vanpooling benefits equal to the considerably higher monthly limit for qualified parking benefits. In 2012 the combined limit for transit pass and vanpooling benefits was only $125 per month, while the 2012 limit for qualified parking benefits was $240. As a result of the legislation, the combined transit pass/vanpooling limit for 2012 rises to $240. Note, however, the 2013 limit has not yet been announced.
Qualified Adoption Assistance Benefits
The income exclusion for employer-provided adoption assistance benefits and the expansion of the adoption tax credit made by the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA) are now permanent. The benefit limit is still $10,000.
Qualified Educational Assistance Programs
The exclusion for qualified educational assistance programs was also subject to EGTRRA’s sunset date and would have expired at the end of 2012. ATRA deleted the EGTRRA sunset date, restored the exclusion and made the exclusion permanent. The benefit limit is still $5,250.
Employer-Provided Child Care
EGTRRA created a tax credit for employers that provide child-care services. ATRA deleted the EGTRRA sunset date, making the credit permanent.
Dependent Care Assistance Plans (DCAP)/Dependent Care Tax Credit (DCTC)
For purposes of the income exclusion for DCAP payments and the DCTC, the deemed earned income of a spouse who is a full-time student or incapable of self-care will remain at $250 per month for one qualifying individual and $500 per month for two or more qualifying individuals. (These amounts were scheduled to decrease to $200 and $400, respectively, in 2013.) EGTRRA’s other changes to the DCTC have also been made permanent. These changes include the amount of employment-related expenses that taxpayers may take into account ($3,000 for one qualifying individual and $6,000 for two or more qualifying individuals), the percentage for determining the credit (35 percent) and the income level at which the credit begins to phase out ($15,000). Certain changes to the earned income credit and child tax credit have also been extended or made permanent, which may be relevant when calculating a participant’s federal income tax savings from claiming the DCTC versus participating in a DCAP.
by Amy M. Gordon, Jacob Mattinson and Susan M. Nash
As part of the Patient Protection and Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) recently released proposed regulations regarding the estimated amount of annual contributions that are required to be paid to HHS from employer-sponsored group health plans to finance state transitional reinsurance programs. The reinsurance programs are intended to help stabilize premiums for coverage in the individual market during the first three years the state health insurance exchanges are operational (2014 through 2016). HHS is estimating the annual contribution rate for 2014 will be $63 per covered life (employees and their dependents). This will undoubtedly impact the overall cost of providing coverage under an employer-sponsored group health plan and should be taken into account by employers for purposes of estimating cost trends.
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