Special Edition: November 2016
Extension for Good-Faith Reporting and 2016 Forms 1095-C and 1094-C
On November 18, 2016, the Internal Revenue Service issued Notice 2016-70, extending both the due date for furnishing individuals with Forms 1095-C and 1095-B, in addition to certain good-faith transition relief to the 2016 information reporting requirements under Code sections 6055 and 6056. …read more
November 2016
Post Election ACA Update:The Future of Healthcare and Compliance
The future of health care benefits, post election, is top of mind for everyone. There are changes coming to the Affordable Care Act which will in turn impact the insurance plan that all Americans purchase. Certainly no one has a lock on exactly what will happen, but there is enough published information to provide some very educated theories. …read more
October 2016
HHS Proposes 2018 OOP Maximums and Marketplace Guidance
“In 2017, the OOP limits will be $7,150 for self-only coverage and $14,300 for other than self-only coverage. HHS has proposed 2018 OOP maximums of $7,350 for self-only coverage and $14,700 for other than self-only coverage…. [A table] summarizes the ACA indexed dollars limits for 2018 and prior years.” …read more
September 2016
Medicare Part D – Creditable Coverage Notification Requirements
The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. For these entities, there are two disclosure requirements that must be done every year……read more
Special Addition: August 2016
DOL Penalties Adjusted for Inflation
In 2015, the Federal Civil Monetary Penalties Inflation Adjustment Act Improvements Act amended the Inflation Adjustment Act of 1990, requiring federal agencies to issue an interim rule by July 1, 2016 to adjust their civil monetary penalties for inflation through October 2015. The Department of Labor (DOL) published an interim final rule on June 30, 2016, to adjust the civil monetary penalties enforced by the DOL for inflation. The catch up adjustments apply to penalties assessed after August 1, 2016, for associated violations that occurred after November 2, 2015…read more
August 2016
Nondiscrimination Rule Expands Administrative Practices, Notice/Language Requirements and Coverage for Certain Plans
Employers and plan sponsors should determine whether they are subject to the regulation. If so, many requirements are already effective. However, they have until October 16, 2016…to comply with the notice requirements and until the first plan year beginning on or after January 1, 2017 to make coverage changes to health insurance or group health plan benefit design…read more
July 2016
Final Rule on Nondiscrimination in Health Programs and Activities
The Department of Health and Human Services (HHS), and specifically the Office of Civil Rights (OCR), issued a final rule on nondiscrimination in health programs and activities under Section 1557 of the Affordable Care Act (ACA). This section of the ACA serves protected classes of individuals whose health coverage may not be denied, cancelled, limited or refused on the basis of race, color, national origin, sex, age, or disability. The final rule clarifies existing nondiscrimination requirements, and sets new implementation standards for Section 1557.
The broad application of this final rule will affect the federal and state Marketplaces, all health care providers and health insurance issuers and employers that receive federal financial assistance. Financial assistance from HHS includes Medicare Part A, student health plans, advanced premium tax credits and many other programs…read more
June 2016
DOL’s Overtime Rules Update
On May 18, 2016, ten months after the publication of its proposed rule, the U.S. Department of Labor (“DOL”) issued its final rule (the “Final Rule”) updating the Fair Labor Standards Act’s (“FLSA”) overtime regulations relating to the executive, administrative, professional and highly compensated employee exemptions.
As a recap, the FLSA generally requires covered employers to pay their employees at least the federal minimum wage (currently $7.25 per hour) for all hours worked and overtime pay at 1.5 times the employee’s regular rate of pay for all hours worked over 40 in a workweek. The FLSA exempts from these rules, however, employees employed in bona fide executive, administrative or professional capacities, or “highly compensated employees.” The DOL has traditionally defined these exempt classifications by requiring the satisfaction of two tests: (1) the salary test; and (2) the standard duties test…read more
Special Edition: June 2016
EEOC Issues New Guidance on Leave of Absence and ADA Accommodations
On May 9, 2016, the U.S. Equal Employment Opportunity Commission (EEOC) issued a new guidance document addressing the intersection of employer-provided leave of absence and the Americans with Disabilities Act (ADA). This document does not create any new EEOC agency policy or propose any new law; rather, it consolidates current guidance on the ADA, employer leave policies, reasonable accommodations, the interactive process, undue hardship, and other relevant sub-topics.
While the EEOC guidance document is not binding law, employers should take it into consideration when making decisions related to leaves of absence…read more
May 2016
HHS Announced New Health Plan Out-of-Pocket Limits for 2017
The Department of Health and Human Services (HHS) has proposed 2017 health plan out-of-pocket (OOP) maximums of $7,150 for self-only coverage and $14,300 for family (other than self-only) coverage.
The Affordable Care Act (ACA) imposes annual OOP maximums on the amount that an enrollee in a nongrandfathered health plan—including self-insured and large-group health plans—must pay for covered essential health benefits through cost-sharing…read more
February 2016
Each year, group health plan sponsors that provide prescription drug coverage to individuals eligible for Medicare Part D must disclose to [CMS] whether that coverage is ‘creditable’ or ‘non-creditable.’ The disclosure obligation applies to all plan sponsors that provide prescription drug coverage, even those that do not offer prescription drug coverage to retirees. Calendar year plans must submit this year’s disclosure to CMS by February 29, 2016…read more
