Allowing Election Changes After Open Enrollment

Question:   Employer’s open enrollment period recently closed for a 1/1 plan year start date.  An employee says she missed the OE deadline by mistake and needs to change her health plan election.  Can the employee change her health plan election before the plan year starts—even though OE has closed? Compliance Team Response: As described below, […]

2018 ACA Reporting Deadline Extended by 30 Days (Again)

In what’s quickly becoming an annual holiday tradition, today the IRS issued IRS Notice 2018-94 extending the deadline for providing the 2018 Forms 1095-B and 1095-C to individuals by 30 days.  This Notice mirrors the same 30-day extension for the 2017 and 2016 ACA reporting. The 2018 ACA reporting deadlines are now as follows: 2018 Forms 1095-B and 1095-C: […]

Form 5500 Small Plan Exemption

Question: When does the Form 5500 small plan exemption apply?  What are the potential penalties for a late Form 5500 filing if the employer did not meet the exemption? Compliance Team Response: Form 5500 Small Plan Exemption The small plan Form 5500 exemption applies for plans with fewer than 100 covered “participants” on the first day […]

Becoming an ALE Subject to the ACA Employer Mandate

Question: An employer with fewer than 50 full-time employees in 2017 has now exceeded 50 full-time employees at some point in 2018.  When is the employer subject to the ACA employer mandate pay or play rules, and when does ACA reporting apply? Compliance Team Response: The ACA employer mandate pay or play rules apply to employers […]

Departments Propose Regulations Permitting HRAs for Individual Policies

On Tuesday, the Departments of Health and Human Services, Labor, and the Treasury (the “Departments”) issued proposed regulations revolutionizing the existing ACA landscape with respect to employers and individual health insurance policies. Proposed Regulations: https://www.federalregister.gov/documents/2018/10/29/2018-23183/health-reimbursement-arrangements-and-other-account-based-group-health-plans News Release: https://www.dol.gov/newsroom/releases/ebsa/ebsa20181023 Fact Sheet: https://www.dol.gov/sites/dolgov/files/OPA/factsheets/wh-hra-factsheet.pdf The proposed regulations would be applicable for plan years beginning on or after January 1, 2020. Prior […]

Late Health Plan Payments on FMLA Leave

Question: When can an employer terminate health benefits for an employee on FMLA leave for failure to timely pay the employee-share of the premium?  What are the employee’s COBRA rights? Compliance Team Response: Payment Must Be More Than 30 Days Late Employers can terminate coverage for an employee on FMLA leave if the employee is more […]

HIPAA Notice of Privacy Practices

Question: Do employers with fully insured medical, dental and vision plans need a HIPAA notice of privacy practices? Compliance Team Response: HIPAA Privacy Notice Generally Not Required for Fully Insured Plans As a starting point, all employer-sponsored group health plans—including fully insured plans—are HIPAA covered entities. For fully insured plans, although the group health plan is […]