January 2021 Compliance Recap

Category: Compliance

January 2021 Compliance Recap

Posted On: February 11, 2021 | Categorized as: Compliance

January 2021 Compliance Recap January was a busy month in the employee benefits world. President Biden issued a memorandum putting a regulatory freeze on new rules. President Biden also issued an executive order on strengthening Medicaid and the Patient Protection and Affordable Care Act (ACA). The Department of Labor (DOL) released inflation-adjusted federal civil penalty amounts. The Centers for Medicare and Medicaid Services (CMS) issued its parameters for the defined standard Medicare Part D prescription drug benefit for 2022. The Internal Revenue Service (IRS) released final rules on individual coverage health reimbursement arrangements (ICHRAs). Former President Trump signed an amendment to the Health Information Technology for Economic and Clinical Health Act (HITECH Act) that requires the Department of Health and Human Services (HHS) to consider recognized security practices that a covered entity or business associate had in place for purposes of HHS determining penalties and audit outcomes. HHS extended the…


EEOC Releases Proposed Wellness Rules under ADA and GINA

Posted On: January 20, 2021 | Categorized as: Compliance, Workplace Wellness

EEOC Releases Proposed Wellness Rules Under ADA and GINA The EEOC recently released proposed language revising the wellness incentive rules under the ADA and GINA. This proposed language is a revision to the rules released in 2016. Below is a summary of the proposed changes and how they may impact wellness programs. Removing the ADA Notice Requirement Currently, employers are required to provide a notice before collecting employee health information. This notice advises employees how their collected health information will be used and disclosed. According to the proposed rules, providing this notice will no longer be necessary. The EEOC states that employers should have these specific policies and procedures in place, however, there is not going to be a guideline that requires them to. Removing the Reasonably Designed Requirement Previously, the requirement stated that any health information collection activity completed by an employee wellness program must be reasonably designed to…


2021 Minimum Wage Increases

Posted On: January 18, 2021 | Categorized as: Compliance

2021 Minimum Wage Increases As of January 1, 2021, several US states increased their minimum wage rate. Please note, however, that some cities or municipalities may have a minimum wage rate even greater than their statewide rate. Below outlines effective wages for states where the rate will be changing. Alaska: $10.34 Arizona: $12.15 Arkansas: $11.00 California: $14.00 (26 or more employees); $13.00 (Fewer than 26 employees) Colorado: $12.32 Connecticut: $13.00 (effective 8/1/2021) Delaware: $10.25 Florida: $10.00 (effective 9/30/2021) Illinois: $11.00 Maine: $12.15 Maryland: $11.75 (15 or more employees); $11.60 (14 or fewer employees) Massachusetts: $13.50 Michigan: $9.87 Minnesota: $10.08 (Large employers – gross receipts greater than $500,000); $8.21 (Small employers) Missouri: $10.30 Montana: $8.75 Nevada: $8.75 (effective 7/1/2021); $9.75 (for employees not offered health insurance) New Jersey: $12.00; $11.00 (seasonal and fewer than 6 employees) New Mexico: $10.50 New York: $12.50 (effective 12/31/2020) Ohio: $8.80 (Large employers) Oregon: $12.75 (effective…


December Compliance Recap

Posted On: January 13, 2021 | Categorized as: Compliance

December was a busy month in the employee benefits world. President Trump signed the Consolidated Appropriations Act, 2021, which includes the No Surprises Act and other group health plan provisions. The Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) issued two interim recommendations for COVID-19 vaccines. The Department of Health and Humans Services (HHS) released a final rule on grandfathered health plans. The Department of Labor (DOL) and Internal Revenue Service (IRS) released advance information copies of the 2020 Form 5500 Annual Return / Report (including Form 5500-SF and Form 5500-EZ) and related instructions. DOL released a final rule on proxy voting and shareholders rights under the Employee Retirement Income Security Act of 1974 (ERISA). The HHS Office for Civil Rights (OCR) issued guidance on Health Insurance Portability and Protection Act of 1996 (HIPAA) covered entities disclosing protected health information for public health purposes due to COVID-19 and…


Consolidated Appropriations Act, 2021: Temporary Health FSA and DCAP Relief

Posted On: January 7, 2021 | Categorized as: Compliance

Consolidated Appropriations Act, 2021 Temporary Health FSA and DCAP Relief The Consolidated Appropriations Act, 2021 (Appropriations Act), enacted on December 27, 2020, contains temporary rules to provide relief for participants in health flexible spending arrangements (FSAs) and dependent care flexible spending arrangements (DCAPs) in light of the COVID-19 pandemic. The Appropriations Act builds on previously issued Internal Revenue Service (IRS) guidance (IRS Notice 2020-29 and 2020-33), by expanding the opportunities for plan sponsors to amend their plans to give employees additional opportunities to use their currently unused FSA and DCAP balances through 2022. Carry Over of Unused Amounts The Appropriations Act provides that FSAs and DCAPs may permit participants to carry over any unused contributions remaining from the 2020 plan year to the plan year ending in 2021. Additionally, FSAs and DCAPs may permit participants to carry over any unused contributions remaining in the FSA or DCAP from the 2021…


Mandatory Coverage of COVID-19 Vaccines under Group Health Plans

Posted On: December 23, 2020 | Categorized as: Compliance, Employee Benefits

Mandatory Coverage of COVID-19 Vaccines Under Group Health Plans On December 11, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization for the Pfizer-BioNTech COVID-19 vaccine (Pfizer vaccine). The following day, December 12, 2020, the Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use of the Pfizer vaccine in persons age 16 years or older for the prevention of COVID-19. Alternative COVID-19 vaccines are likely to be approved by the FDA under emergency authority in the coming weeks. Group health plans are encouraged to prepare to cover the cost of the Pfizer and other approved COVID-19 vaccines. Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), non-grandfathered individual and employer-sponsored group health plans are required to cover the entire cost of preventative services by not imposing cost-sharing in the form of deductibles, copays, coinsurance or other amounts on…


Congress Passes New $1.4 Trillion Stimulus & COVID-19 Relief Bill and Awaits President’s Signature

Posted On: December 23, 2020 | Categorized as: Compliance

Congress Passes New $1.4 Trillion Stimulus & COVID-19 Relief Bill and Awaits President's Signature Details have emerged on the new $1.4 trillion omnibus spending bill which provides a $900 billion COVID-19 Stimulus package. The bill awaits President Trump’s signature and as of last night, he requested that Congress amend the bill to increase the amount of stimulus checks. In the meantime, below highlights many important facets of the bill as it stands now relating to employers and the benefits industry, but as more information becomes available, we will provide subsequential communications. In relation to employee benefits, the bill includes relief for employees participating in Flexible Spending Accounts (FSA), a surprise-billing ban, and additional transparency provisions: Flexible Spending Accounts (FSAs) Employees will be able to rollover unused amounts in their health and dependent care FSAs from 2020 to 2021 and from 2021 to 2022. Employers are also allowed to provide employees…


Blue Cross Blue Shield Association Tentative $2.67 Billion Antitrust Settlement

Posted On: December 16, 2020 | Categorized as: Compliance

Blue Cross Blue Shield Association Tentative $2.67 Billion Antitrust Settlement  Blue Cross Blue Shield Association (BCBSA) has recently reached a tentative $2.67 billion settlement arising out of a class action lawsuit filed more than eight years ago by subscribers seeking injunctive and compensatory relief arising out of BCBSA’s alleged violation of federal antitrust laws. The settlement will result in the dismissal of the case and a finding of no liability against BCBSA for the subscriber’s claims, which BCBSA continues to reject in their statement regarding the litigation. Alleged Violations The subscribers alleged that BCBSA violated several provisions of the Sherman Antitrust Act, which is a federal law prohibiting interference with trade and competition, by entering into an unlawful agreement that interfered with competition in the health insurance market by: (1) allocating geographic territories among members of the Blues association, thereby limiting subscriber choice; (2) limiting Blue member plans from competing…


November Compliance Recap

Posted On: December 11, 2020 | Categorized as: Compliance

November Compliance Recap November was a relatively busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) heard oral arguments in the case of California v. Texas, which is the case challenging the constitutionality of the ACA. The Internal Revenue Service (IRS) released the updated Patient-Centered Outcomes Research Institute (PCORI) fee for plan years that end on or after October 1, 2020, and before October 1, 2021. The Department of Labor (DOL) released a final rule on financial factors in selecting plan investments that imposes requirements on ERISA plan fiduciaries under their duties of loyalty and general prudence. The IRS released an information letter on the relief available under IRS Notice 2020-29 as it applies to dependent care flexible spending arrangements (DCAPs). The IRS also released an information letter on unused qualified transportation benefits due to COVID-19. The Department of Health and Human Services (HHS) released an…


Updated PCORI Fee Released

Posted On: December 2, 2020 | Categorized as: Compliance

Updated PCORI Fee Released Employers that sponsor certain self-insured health plans are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Under the Affordable Care Act, PCORI fees were originally scheduled to apply to policy or plan years ending on or after Oct. 1, 2012 and before Oct. 1, 2019. However, in Dec. 2019, PCORI fees were extended for an additional 10 years. Thus, the fee continues to apply for the 2020-2029 fiscal years. New Fee The IRS announced in Notice 2020-84 for plan years that ended on or after October 1, 2020 through Sept. 30, 2021, the fee will adjust to $2.66 per participant. Employers must report and pay the required PCORI fees annually via IRS Form 720 by July 31 of the year following the last day of the plan year. If you have any questions, please contact Innovative Benefit Planning at icomply@ibpllc.com.


October Compliance Recap

Posted On: November 16, 2020 | Categorized as: Compliance

October was a busy month in the employee benefits world. The Department of Health and Human Services (HHS) renewed the public health emergency due to COVID-19 which took effect on October 23, 2020. The Internal Revenue Service (IRS) issued Notice 2020-76 regarding deadline extensions and requirements for reporting of group health coverage offered in 2020 under the Patient Protection and Affordable Care Act (ACA) as it has done in prior years. The IRS released final instructions for both the 1094-B and 1095-B forms and the 1094-C and 1095-C forms and the final forms for 1094-B, 1095-B, 1094-C, and 1095-C. The IRS released Notice 2020-79 and Rev. Proc. 2020-45 regarding health plan limits as well as various compensation, benefit, and contribution levels under qualified retirement plans for 2021. The Department of Labor (DOL), HHS, and the Department of the Treasury (Treasury) (collectively, the Departments), released interim final rules regarding implementation of…


Final Rules on Coverage Transparency

Posted On: November 16, 2020 | Categorized as: Compliance, Employee Benefits

Final Rules on Coverage Transparency On October 29, 2020, the Internal Revenue Service (IRS), Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, Departments), released final rules on coverage transparency, in order to provide health coverage recipients with an estimate of their potential cost-sharing liability for health related services prior to the receipt of care. The final rules require group health plans and insurance issuers in the individual and group markets to disclose cost-sharing information and negotiated rates in electronic or paper form. The final rules also allow issuers to reward plan enrollees with “shared savings payments,” without running afoul of medical loss ratio (MLR) requirements. Issuers are permitted to provide employees who use lower-priced providers with a percentage of the savings relative to a benchmark. Effective Dates Public Disclosure of Negotiated Rates and Historical Allowed Amounts: January 1, 2022 Disclosure of Cost Information: January…


NJ Employers Must Adhere to Latest Executive Orders Mandating Health and Safety Protocols for COVID-19

Posted On: November 4, 2020 | Categorized as: Compliance

NJ Employers Must Adhere to Latest Executive Orders Mandating Health and Safety Protocols for COVID-19 On October 28, 2020, New Jersey Governor Phil Murphy signed Executive Order No. 192 (EO 192), which mandates that New Jersey employers abide by certain health and safety standards in an effort to protect employees and other individuals at workplaces during the pandemic. The executive order, effective 6:00am November 5th,  will take the following actions in three areas: Workplace health and safety standards to cover all NJ workers: The executive order will require both private and public sector employers to follow health and safety protocols that will serve to protect their in-person workforces.  The Order mandates all employers: Require individuals at the worksite to maintain at least six feet of distance from others to the maximum extent possible; Require employees, customers, visitors, and other individuals entering the worksite to wear cloth or disposable face masks…


2021 IRS Contribution Limits for FSA and Commuter Benefits

Posted On: November 2, 2020 | Categorized as: Compliance

2021 IRS Contribution Limits for FSA and Commuter Benefits On Tuesday, the IRS released 2021 contribution limits for medical FSA and Commuter Benefits for 2021. There are no changes to flexible spending account (FSA) and commuter benefits contribution limits for 2021. The IRS did adjust the contribution limits for adoption assistance programs, increasing the limit from $14,300 to $14,440. Last, HSA contribution limits were announced earlier this year. The limit for an individual is $3,600, while the family contribution limit increased to $7,200. The current and new contribution limits include: Medical FSA Contribution Limit remained the same: $2750 Monthly Commuter Benefits Contribution Limit remained the same: $270 HSA Contribution Limit: Single - $3600; Family - $7200 Adoption Assistance Limit: Increased to $14,440 For a downloadable PDF, click here. If you have any questions about 2021 limits, please don’t hesitate to reach out to your account management team or email us…


IRS Announces 2021 Plan Limitations

Posted On: November 2, 2020 | Categorized as: Compliance, Retirement Plans

IRS Announces 2021 Plan Limitations The IRS has recently announced the qualified plan limitations for 2021, which are determined based on annual increases in the cost of living index. Because there was only a modest increase in the index, most of the plan limits have not changed from 2020. For your convenience we have included a downloadable compliance bulletin, detailing the current and new plan limitations: 401k Deferral Limit remained the same: $19,500 The maximum amount that can be contributed by and for a participant to a defined contribution plan - Increased to $58,000 The maximum amount of compensation taken into account for plan purposes - Increased to $290,000 The catch-up contribution for participants who have attained age 50 remained the same: $6,500 The compensation-based definition of highly compensated employee remained the same: $130,000 The maximum annual benefit payable from a defined benefit plan remained the same: $230,000 The definition…


CARES ACT & FFCRA Tax Credits for Eligible Employers

Posted On: October 26, 2020 | Categorized as: Compliance

CARES ACT & FFCRA Tax Credits for Eligible Employers Eligible employers are entitled to receive a credit in the full amount of the required sick leave and family leave, plus related health plan expenses and the employer’s share of Medicare tax on the leave, for the period of April 1, 2020, through December 31, 2020.  The refundable credit is applied against certain employment taxes on wages paid to all employees. Eligible employers can reduce federal employment tax deposits in anticipation of the credit.  They can also request an advance of the paid sick and family leave credits for any amounts not covered by the reduction in deposits. The advanced payments will be issued by paper check to employers. To learn more about these tax credits, click here.


3 ACA Reporting Errors and The Pandemic’s Impact

Posted On: October 22, 2020 | Categorized as: Compliance, Employee Benefits

3 ACA Reporting Errors and The Pandemic’s Impact As we approach the end of 2020, we must consider how the various enrollment fluctuations due to the COVID-19 Pandemic will impact the ACA Employer Mandate and the already tedious 1095/1094 ACA Reporting. The IRS recently granted a March 2nd deadline extension for the 1095 reporting and this extra time will likely be needed for employers to accurately audit their data as we are expecting to see additional errors due to furloughs, layoffs and coverage extensions. Prior to filing, employers should audit their reporting for the following common errors to avoid an unnecessary penalty letter. Enrollment Changes and Code Errors For each month an employee is offered coverage and one of codes 1B through 1E is entered in line 14, an employee should have a dollar amount indicated in line 15. If there are blank entries this could trigger a penalty for…


September Compliance Recap

Posted On: October 15, 2020 | Categorized as: Compliance

September Compliance Recap September was a relatively quiet month in the employee benefits world. President Trump issued an executive order on An America-First Healthcare Plan, noting the Administration’s actions on healthcare and planned actions going forward. A federal district court halted the repeal of certain provisions of the prior final rule on Section 1557 of the Patient Protection and Affordable Care Act (ACA). The Department of Labor (DOL) released additional temporary regulations on the leave laws under the Families First Coronavirus Response Act (FFCRA) in response to a federal district court’s invalidation of certain provisions under the original temporary regulations issued by the DOL. The Office for Civil Rights (OCR) and the Office of the National Coordinator for Health Information Technology (ONC) released the Department of Health and Human Services (HHS) Security Risk Assessment Tool Version 3.2. The DOL released a final rule on Promoting Regulatory Openness Through Good Guidance…


Have You Received an MLR Rebate Check? What To Do Next?

Posted On: October 9, 2020 | Categorized as: Compliance, Employee Benefits

Have You Received an MLR Rebate Check? What To Do Next? The Affordable Care Act requires health insurance carriers to spend at least 80-85 percent of premium dollars on medical care and healthcare quality improvement. If the carrier does not meet this medical loss ratio (MLR) obligation, it must give affected customers a rebate.  Rebates must be distributed by the carriers each year by September 30. Any employer that receives a refund then needs process and distribute within 90 days to avoid triggering ERISA trust requirements. For your convenience we have included more information regarding this topic in our compliance bulletin, including: How should the rebate be divided? Are former plan participants entitled to a share in the rebate? How may the employer use the rebate? How should the rebate be provided? Additional Q&As on how the rebate should be used If you have any questions about distribution or how…


IRS Extends ACA Reporting Deadline for Furnishing Statements for 2020 from February 1 to March 2, 2021

Posted On: October 7, 2020 | Categorized as: Compliance

IRS Extends ACA Reporting Deadline for Furnishing Statements for 2020 from February 1 to March 2, 2021 As the deadline for reporting of group health coverage offered in 2020 under the Patient Protection and Affordable Care Act (ACA) approaches, the Internal Revenue Services (IRS) has issued IRS Notice 2020-76 (Notice) regarding deadline extensions and requirements as it has done in prior years. In past years, the IRS provided relief to employers who made a good faith effort to comply with the information reporting requirements and determined that they would not be subject to penalties for failure to correctly or completely file. This did not apply to employers that failed to timely file or furnish a statement. Under the Notice, this relief has been extended for group health coverage offered in 2020. As in prior years, the relief is applied only to incorrect or incomplete information reported on the statement or…


Feedback From Our Happy Customers



Need a custom plan designed for your team?

Schedule a Consultation

Contact Us Now To Get Your Business Covered