Judge Rules for HHS in Price Transparency Case

Category: Employee Benefits

Judge Rules for HHS in Price Transparency Case

Posted On: June 25, 2020 | Categorized as: Employee Benefits

Judge Rules for HHS in Price Transparency Case

Judge Rules for HHS in Price Transparency Case A federal judge ruled against the American Hospital Association (AHA) on Tuesday in its lawsuit attempting to block an HHS rule pushing for price transparency. The judge ruled in favor of the department, which requires hospitals to reveal private, negotiated rates with insurers beginning Jan. 1.  The AHA stated they are requesting an expedited review as they are concerned with the significant burden this will place on hospitals when resources are already stretched thin as a result of the pandemic and increased patient care needed.  Click here to read the full brief.  



IRS Releases Two New COVID-19 Notices

Posted On: May 13, 2020 | Categorized as: Employee Benefits, HR Consulting

IRS Releases Two New COVID-19 Notices To provide additional relief to Americans during these challenging times, the IRS released Notice 2020-29 and 2020-33. These notices provided new relaxed rules for 2020 for making elections under Cafeteria plans, using amounts during a grace period or carryover period changes to the method determining the carryover amounts under Health Flexible Spending Accounts (FSAs)  and clarifying which premiums can be reimbursed under Individual Coverage Health Reimbursement Arrangements (ICHRAs). Notice 2020-29 In Notice 2020-29, the IRS provides for increased flexibility with respect to mid-year elections under a cafeteria plan during calendar year 2020 related to employer sponsored health coverage, Health FSAs and Dependent Care Assistance Plans (DCAPs). This notice also provides increased flexibility with respect to grace periods and carryover periods to apply unused amounts in health FSAs to medical care expenses incurred through December 31, 2020, and unused amounts in dependent care assistance programs…


Open Enrollment and Outcomes Based Health Screenings Options During COVID-19

Posted On: May 5, 2020 | Categorized as: Employee Benefits

open enrollment options

Open Enrollment and Outcomes Based Health Screenings Options During COVID-19 Due to the COVID-19 outbreak, employers who were planning on offering on-site health screenings tied to payroll deductions are unfortunately being forced to consider other options.  Thankfully, the screening vendors have been flexible with delaying screening dates. As an employer, if you were offering premium discounts based on screening results, you must decide what to do with your payroll deductions and incentives now that screenings will not be occurring before the start of your new plan year. What options do employers with outcomes based wellness plans have? Many employers have expressed interest in keeping the current payroll deduction rates in place for a few more months. Unfortunately, under HIPAA’s rules regarding health contingent wellness programs, this option is not allowed.  Members must be given the opportunity to screen and earn incentives at least once every 12 months. To comply with…


Final Rule on the Extension of Certain Timeframes for Employee Benefit Plans Due to COVID-19

Posted On: May 4, 2020 | Categorized as: Compliance, Employee Benefits

On March 13, 2020, President Trump issued the Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak and by separate letter made a determination, under Section 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, that a national emergency exists nationwide beginning March 1, 2020, as the result of the COVID-19 outbreak. The Department of Labor (DOL) and the Department of the Treasury (Treasury) issued a final rule that extends certain timeframes under the Employee Retirement Income Security Act (ERISA) and Internal Revenue Code (IRC) for group health plans, disability, and other welfare plans, pension plans, and participants and beneficiaries of these plans during the COVID-19 national emergency. The timing extensions are issued to help alleviate problems faced by health plans to comply with strict ERISA and IRC timeframes and problems faced by participants and beneficiaries in exercising their rights under health plans…


Paycheck Protection Program and Health Care Enhancement Act

Posted On: April 29, 2020 | Categorized as: Compliance, Employee Benefits

PPP blocks

Paycheck Protection Program and Health Care Enhancement ActIn response to the spread of the 2019 novel coronavirus (COVID-19), President Trump signed the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA) into law on April 24, 2020. The PPPHCEA is phase 3.5 in Congress' response to the COVID-19 pandemic following the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, and the Families First Coronavirus Response Act (FFCRA). The PPPHCEA is a $484 billion package that increases amounts authorized and appropriated for the Paycheck Protection Program (PPP) discussed in our April 2, 2020, and April 13, 2020, Advisors for emergency economic injury disaster loans (EIDL) and for emergency grants under the CARES Act. The PPPHCEA also provides additional funding for health care providers.PPP FundingThe PPP was established under the CARES Act to provide small employers with an incentive to keep workers on their…


Relaxed Life, Disability and Long-Term Care Insurance Underwriting

Posted On: April 28, 2020 | Categorized as: Employee Benefits

As a result of the COVID-19 National Emergency, insurance companies have adapted to help individuals easily secure protection and obtain insurance without a medical exam that requires a nurse to visit your home or office. This is a TEMPORARY change that will likely end when social distancing can stop. How This Can help You:  You may get approved for the insurance products listed below without having to complete a medical exam or provide fluids during the underwriting process: Term and & Permanent Insurance Age 18-65: Up to $5,000,000 of death benefit Age 66-70: Up to $3,000,000 of death benefit Long-Term Care Insurance No limit on monthly LTC benefit Disability Insurance Age 18-45: No limit on monthly benefit Simplified Application Process Go to the insurance carrier’s online submission tool with Innovative to complete the electronic application. Electronically sign any necessary forms for your application. The insurance carrier will schedule and conduct…


Gov. Murphy Signs Executive Order Granting Grace Periods for Insurance Premium Payments

Posted On: April 14, 2020 | Categorized as: Compliance, Employee Benefits

Gov. Murphy Signs Executive Order Granting Grace Periods for Insurance Premium Payments On April 9, 2020, New Jersey Governor Phil Murphy signed Executive Order No. 123, extending grace periods during which certain insurance companies, including health and dental insurers, life insurers, and property and casualty insurers, will not be able to cancel policies for nonpayment of premiums. Grace Periods for Small Group Employer (0-50 EE’s) Grace period may be initially applied to April or May premium as the policyholder determines and will continue for 60 days from that date. Coverage MUST remain in force and claims must be paid not pended. If a carrier has already provided a grace period for April premium, the time period for which a grace period has already been granted shall be applied toward the emergency grace period. Grace period only applies to policyholders that were in good standing with their insurance carrier on March 1,…


CARES Act: Impact on Employee Benefits

Posted On: April 7, 2020 | Categorized as: Compliance, Employee Benefits

CARES Act: Impact on Employee Benefits On March 27, 2020, Congress passed, and the President signed, an unprecedented 2 trillion-dollar stimulus and relief package into law, named the Coronavirus Aid, Relief, and Economic Security Act or the CARES Act. This act provides direct stimulus relief to corporations and individuals. While there are many facets to this act, this brief serves to highlight the changes to employee benefits due to the CARES Act. Expanded COVID-19 Testing The Families First Coronavirus Response Act (FFCRA) required group health plans and insurers to provide coverage of certain diagnostic COVID-19 testing and related services without cost-sharing and without preauthorization. The CARES Act expands on these provisions: All testing for COVID-19 must be covered without cost-sharing for fully insured and self-funded plans. In addition to tests approved by the FDA, this includes tests for which: the developer has requested, or intends to request, an emergency use…


COVID-19 Employer Considerations Regarding Employment Decisions and Plan Coverage Changes

Posted On: April 7, 2020 | Categorized as: Employee Benefits, HR Consulting

Due to the recent national health crisis in our country, many employers are considering the best way to handle a temporary economic turndown to best position themselves for recovery once the pandemic ceases and businesses can begin to return to some sense of normalcy. In addition, many employers are also navigating the benefit coverage changes being made by their insurance carrier(s) or by state and/or federal mandates which may include cost considerations, plan document revisions and employee notifications. Below are some explanations regarding various workplace employment options and health plan considerations. Employer/Employee Relationship One of the decisions employers are faced with is how to handle their workforce. Employers and insurance companies are using many terms to describe employer/employee relationships such as reduction in hours. furlough, temporary layoff, and permanent layoff. Many employers desire to keep employee benefits intact during this period. It is important to understand the differences and how…


Telemedicine Wait Times

Posted On: April 2, 2020 | Categorized as: Employee Benefits

In light of the recent COVID-19 (coronavirus) outbreak. The CDC recommends leveraging telemedicine for your unique medical needs to help limit the spread of the virus by eliminating the risk of exposure to the ER, urgent care, and primary care offices. They are recommending members schedule their virtual visits rather than remain in the virtual waiting room for an unknown period of time. For more information, download PDF here.  Please contact the Innovative Benefit Planning team if you have any further questions.


COVID-19: Carrier Enhancements

Posted On: March 17, 2020 | Categorized as: Employee Benefits

COVID-19: Carrier Enhancements March 17th, 2020 Due to the outbreak of COVID-19 in the United States, the CEO’s of major US health insurance companies met at the White House on March 10, 2020 and agreed to waive costs for certain services such as the COVID-19 test, telemedicine services and prescription refill limitations. Whether you are an employer sponsoring a fully-insured or self-funded plan, it is important to understand the insurance companies response to how certain benefits are being enhanced to address this global pandemic.  For the fully-insured health plans these changes are happening automatically.  Self-funded plans thus far have the option to adopt these enhancements. On March 11th, The Internal Revenue Service advised that high-deductible health plans (HDHPs) can pay for COVID-19 related testing and treatment, without jeopardizing their status. This also means that an individual with an HDHP that covers these costs may continue to contribute to a health…


Ways Employers Can Deal With Employee Student Loan Debt

Posted On: February 25, 2020 | Categorized as: Employee Benefits, Retirement Plans

Ways Employers Can Deal With Employee Student Loan Debt February 25th, 2020 Student debt has increased dramatically in recent years, creating a financial burden on employees’ ability to save for retirement. Many employers have begun implementing programs to help employees manage student loan debt. Millennials (and their families) are often burdened with significant student loan debt. More than 70 million millennials make up 50% of today’s workforce, and that number is growing. Also, many older workers in the “sandwich generation” are saving for their children’s college. Both of these scenarios provide opportunities for employers to design programs that help employees reduce their financial stress (which often affects productivity), as well as make the company more attractive to talented candidates. To review your options, feel free to contact Innovative Benefit Planning. We have extensive experience guiding clients through these decisions, and would be more than happy to help.


The ACA’s Cadillac, HIT and Medical Device Taxes Are Repealed; PCORI Fee Extended for 10 More Years

Posted On: December 24, 2019 | Categorized as: Compliance, Employee Benefits

On December 20, 2019, the President signed a $1.4 trillion spending bill that will fund the federal government through September 30, 2020. The bill signed by the President specifically includes the repeal of three major taxes that fund the Affordable Care Act (ACA), including the “Cadillac” tax, the health insurance tax (HIT), and the medical device tax. The excise, or “Cadillac,” tax is a provision of the 2010 ACA law that assesses employer penalties for offering health plans exceeding a certain value, expected to take effect in January 2022. While the Cadillac tax was designed to penalize high-value plans, analyses showed that even moderately priced plans stood to be affected by its implementation. The Cadillac tax has been unpopular with both lawmakers and employers, and its implementation has been repeatedly delayed. With this spending bill, the tax has been fully repealed and will not take effect. Not only does the…


IRS Extends ACA Reporting Deadline for Furnishing Statements for 2019 from January 31 to March 2, 2020

Posted On: December 3, 2019 | Categorized as: Compliance, Employee Benefits

In Notice 2019-63, the IRS extended the 2020 deadline for employers and insurers to furnish individual statements on 2019 health coverage and full-time employee status (Forms 1095-B and 1095-C) from January 31 to March 2. The notice also extends the good-faith penalty relief to 2019 for incorrect or incomplete reports due in 2020. In the Notice, the IRS did not extend the due date for filing the 1094 and 1095 forms with the IRS. If filing by paper, forms are due February 28, 2020, or March 31, 2020, if filing electronically. Please remember that filers can still take advantage of an automatic 30-day extension of the IRS filing deadline by submitting Form 8809 before the relevant due date. IRS indicated that it will continue to require the Filing of Form 1095-B and the completion of Part III of Form 1095-C for 2019. Notice 2019-63 also extends the good-faith relief to 2019. This relief applies to missing and inaccurate taxpayer identification numbers…


2020 IRS Contribution Limits Released

Posted On: November 8, 2019 | Categorized as: Compliance, Employee Benefits

On Wednesday, the IRS announced new contribution limits for medical FSA, Commuter Benefit, and HSA plans for 2020.  The FSA contribution will increase to $2,750, a $50 increase from current limits. The HSA contribution limit for individuals with a high deductible health plan (HDHP) will likewise be raised from $3,500 for an individual and $7,000 for a family to $3,550 for an individual and $7,100 for a family.  The IRS also adjusted the contribution limits for adoption assistance programs, increasing the limit from $14, 080 to $14,300. The current and new contribution limits are listed below:   2019 2020 Medical FSA Contribution Limit   $2,700 $2,750 Monthly Commuter Benefits Contribution Limit $265 $270 HSA Contribution Limit Single:   $3,500 Family: $7,000 Single:   $3,550 Family: $7,100 Adoption Assistance Limit   $14,080 $14,300


September 2019 Compliance Recap

Posted On: October 8, 2019 | Categorized as: Compliance, Employee Benefits

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). The Internal Revenue Service (IRS) published proposed rules regarding affordability safe harbors and Section 105(h) nondiscrimination rules as applied to individual coverage health reimbursement arrangements (ICHRAs). The IRS also announced that the health insurance providers fee will resume for 2020. The IRS released an information letter regarding transition relief and whether employer shared responsibility penalties may be waived under the Patient Protection and Affordable Care Act. The DOL, Department of Health and Human Services (HHS), and Treasury (collectively, the "Departments") released final FAQs on mental health parity. The DOL issued an opinion letter regarding delaying Family and Medical Leave Act (FMLA) leave. The DOL also issued an opinion letter regarding whether employer contributions to health savings accounts (HSAs) are earnings subject to wage garnishment…


Innovative Benefit Planning Named “Best of Biz 2019”

Posted On: August 27, 2019 | Categorized as: Company News, Employee Benefits

Innovative Benefit Planning has been named by South Jersey Biz, as one of their 2019 Best of Biz recipients. The Best of Biz award recognizes 102 of region’s most esteemed service providers and we are proud to say that Innovative has been selected for their “Employee Benefits” category. According to South Jersey Biz, “The past few months were quite busy as we spent hours researching businesses from all over the region, as well as counting your votes for our annual Best of Biz−and your voices were heard. From banking, construction, law firms and real estate to education, engineering, IT Support and staffing agencies to name a few, we listed companies that are not only the best at what they do, they are trustworthy and respected in their fields.” At Innovative, we strive to go above and beyond for our clients to deliver the best results possible so it’s an honor…


Additional Preventive Care Benefits Permitted for High Deductible Plans

Posted On: August 8, 2019 | Categorized as: Compliance, Employee Benefits

In Executive Order 13877, issued June 2019, the Treasury Department and the IRS were directed to consider ways to expand the use and flexibility of HSA's and HDHP's. In response to the Executive Order, the Treasury Department issued guidance on July 17, 2019, that lists newly identified preventive care items and services that may now be covered by a high deductible health plan. Read the complete executive order details here, including the list of identified items: HDPS Additional Preventive Care HDHP sponsors should review the new guidance promptly. For some HDHPs, plan sponsors may seek to expand the list of preventive care items and services covered under the HDHP. For other HDHPs, which already treated certain chronic care expenses as preventive, plan sponsors will need to consider whether changes to that list of preventive items and services are now necessary or appropriate. If you have any questions regarding these additional…


Pennsylvania Medical Marijuana Updates

Posted On: July 23, 2019 | Categorized as: Compliance, Employee Benefits

Effective July 20, 2019, Pennsylvania will recognize anxiety and Tourette Syndrome as serious medical conditions in the medical marijuana program.   The Pennsylvania Department of Health stated that the decision came after a research-based recommendation by the state’s Medical Marijuana Advisory Board, followed by Health Secretary Rachel Levine’s careful review of the medical literature available about the conditions. You can read more in Pennsylvania’s press release: https://www.media.pa.gov/Pages/Health-Details.aspx?newsid=620 The Pennsylvania Medical Marijuana Act allows individuals with a serious medical condition to receive a certification to use medical marijuana obtained from a licensed dispensary in the Commonwealth. Employers need to be familiar with the Act and prepared to properly manage employees at the worksite that are certified to use medical marijuana. The Act provides protections for employees certified to use medical marijuana and in particular, it prohibits employers from discriminating or taking an adverse action against an employee “solely on the basis of the employee’s…


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