Benefits Buzz – ACA Pay or Play Penalties Increase for 2023
On Aug. 16, 2022, the IRS updated its FAQs on the Affordable Care Act’s (ACA) employer shared responsibility (pay or play) rules to include updated penalty amounts for 2023. The adjusted $2,000 penalty amount is $2,880 and the adjusted $3,000 penalty amount is $4,320.
Pay or Play Penalty Calculations
An applicable large employer (ALE) is only liable for a penalty if at least one full-time employee receives a subsidy for Exchange coverage. Employees who are offered affordable, minimum value coverage are generally not eligible for these subsidies.
Benefits Buzz – Federal Guidance on Reproductive Health Care
In the wake of the Supreme Court’s ruling allowing states to regulate abortion, federal agencies have been issuing new guidance focused on reproductive health care.
HIPAA Guidance
New guidance addresses covered entities’ obligation under the HIPAA Privacy Rule to safeguard patients’ protected health information (PHI) related to reproductive health care, including abortions. It focuses on health care providers but refers to covered entities, including health plans.
Benefits Buzz – DOL Guidance on FMLA and Mental Health Conditions
The Department of Labor’s (DOL) Wage and Hour Division has released new resources on workers’ rights to leave for mental health conditions under the Family and Medical Leave Act (FMLA). The DOL said it published the new guidance in recognition of Mental Health Awareness Month.
- New DOL Fact Sheet and FAQs
- Mental Health as a Serious Health Condition
- HIPAA Guidance on Audio-only Telehealth
Benefits Buzz – HSA/HDHP Limits Increase for 2023
On April 29, 2022, the IRS released Revenue Procedure 2022-24 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2023. The IRS is required to publish these limits by June 1 of each year. These limits include:
- The maximum HSA contribution limit;
- The minimum deductible amount for HDHPs; and
- The maximum out-of-pocket expense limit for HDHPs.
Benefits Buzz – IRS Suspends Notices to Delinquent Filers of Some Returns
On March 22, 2022, the IRS announced it will temporarily stop sending written notices to certain entities that fall behind on filing obligations related to Forms 5500, 990 and others. The IRS usually mails these notices to tax-exempt or governmental entities in case of a delinquent return. The suspension does not relieve entities of any filing deadlines or obligations.
Affected Notices
The suspension applies to these notices:
- Reminder Notice About Your Form 5500-EZ or 5500-SF Filing Requirement
- Form 940 Not Required—Federal, State and Local Government Agencies
- First Taxpayer Delinquency Investigation Notice—Forms 990/990EZ/990N, 990PF, 990T, 5227, 1120-POL and 990/990EZ
- First Delinquency Notice—Forms 5500 and 5500-SF
- Second Delinquency Notice—Form 5500
Benefits Buzz – Telehealth Coverage for HDHPs Extended
A spending bill signed into law on March 15, 2022, extends the ability of high-deductible health plans (HDHPs) to provide benefits for telehealth or other remote care services before plan deductibles have been met without jeopardizing health savings account (HSA) eligibility. This extension applies to any telehealth services from April 2022 through the end of the year.
Federal Protections for Gender-affirming Care
The guideline recommends counseling for midlife women aged 40 to 60 years with normal or oThe Department of Health and Human Services recently issued guidance on federal civil rights protections and health privacy laws that apply to gender-affirming care.
- Federal Civil Rights Protections
- Federal Health Privacy Laws
Benefits Buzz – Women’s Preventive Services Guidelines Updated
The Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) recently updated its preventive services guidelines to expand the list of women’s preventive services that group health plans are required to cover under the Affordable Care Act (ACA).
Preventing Obesity in Midlife Women.
The guideline recommends counseling for midlife women aged 40 to 60 years with normal or overweight body mass index to prevent obesity. In addition, the update revises the following five services:
- Breastfeeding Services and Supplies.
- Contraception.
- Screening for HIV Infection.
- Counseling for Sexually Transmitted Infections (STIs).
- Well-woman Preventive Visits.
Benefits Buzz – Supreme Court will Review Federal Vaccine Mandates
On Dec. 22, 2021, the U.S. Supreme Court announced that it will hear oral arguments regarding whether two federal vaccine requirements can be enforced while legal appeals are in process. On Jan. 7, 2022, the Court will consider requests on the Occupational Safety and Health Administration’s (OSHA) federal emergency temporary standard (ETS) for COVID-19 and the Centers for Medicare & Medicaid Services (CMS) emergency rule requiring COVID-19 vaccination of certain health care workers.
Increased Civil Penalty Amounts for Certain Violations
Effective Nov. 15, 2021, the U.S. Department of Health and Human Services (HHS) has increased the following key penalties affecting group health plans:
- Summary of Benefits and Coverage (SBC)
- Medicare Secondary Payer (MSP)
- HIPAA privacy and security rules
Client and Employee Resources
The more your employees understand your benefit plans the more they become educated, empowered consumers. The programs you provide will also gain an enhanced value.
As your strategic partners in employee benefits, we can provide multiple avenues of ongoing support, including:
- Employee Meetings (English and Spanish)
- Webcasts
- Payroll Stuffers
- Poster Campaigns
- Newsletters
Carrier Directories
E-Verify is a web-based system that allows enrolled employers to confirm the eligibility of their employees to work in the United States. Click the image below to begin.
