⛔IRA Changes to Medicare Part D May Impact Employer Plans⛔ (March)
The Inflation Reduction Act of 2022 (IRA) includes several cost-reduction provisions to Medicare Part D plans that are designed to help beneficiaries but may also impact employer-sponsored health plans.
891339 IRA Changes to Medicare Part D May Impact Employer Plans.docx
❗Employers Should Start Preparing for 2025 RxDC Reporting❗ (March)
Group health plans and health insurance issuers must annually submit detailed information on prescription drug and health care spending to the Centers for Medicare & Medicaid Services {CMS). This reporting is referred to as the “prescription drug data collection” (or “RxDC report”). The next RxDC report is due by Sunday, June 1, 2025, covering data for 2024.
Employers Should Start Preparing for 2025 RxDC Reporting.docx
Compliance Tracker – October
No key compliance deadlines for November 2024.
Year-end Compliance Reminders
As 2024 approaches its end, employers should review their compliance to ensure that all required activities will be completed by the end of the year. In addition, as the end of the year approaches,
employers should consider reminding employees what happens to unused funds in their health FSAs, dependent care FSAs and HRAs at the end of the year and remind employees of the company’s policy for unused PTO at the end of the year.
Compliance Bulletin – Deadline for Submitting Gag Clause Attestation Is Dec. 31, 2024
Effective in 2020, the Consolidated Appropriations Act, 2021 (CAA) prohibits health plans and health insurance issuers from entering into contracts with health care providers, third-party administrators (TPAs) or other service providers that contain gag clauses (i.e., clauses restricting the plan or issuer from providing, accessing or sharing certain information about provider price and quality and de-identified claims).
Plans and issuers must annually submit an attestation of compliance with the CAA’s gag clause prohibition to the Departments of Labor, Health and Human Services, and the Treasury (Departments). The first attestation was due on Dec. 31, 2023. The next attestation is due Dec. 31, 2024, covering the period since the last attestation.
Compliance Bulletin – Educational Assistance Programs Can Help Pay Student Loans Through 2025
The IRS is reminding employers who offer educational assistance programs that they can also use them to help pay for their employees’ student loans. Though educational assistance programs have been available for many years, the option to use them to pay for student loans has only been available for payments made after March 27, 2020. Under current law, this student loan provision is set to expire Dec. 31, 2025.
In most cases, educational benefits are excluded from federal income tax withholding, Social Security tax, Medicare tax and federal employment (or FUTA) tax. By law, tax-free benefits under an educational assistance program are limited to $5,250 per employee per year, and assistance provided above this level is typically taxable as wages.
Compliance Overview – What Employers Should Know About Seasonal Employment
Many organizations rely on seasonal workers to supplement their regular workforce during peak times. This often occurs during busy seasons or holidays, as there’s an influx of business activity. While similarities exist, there are important differences between seasonal and regular employment. Due to these differences, hiring and reliance on seasonal workers can present significant and unexpected challenges for employers.
Compliance Bulletin – Telehealth Exception for HDHP/HSA Plans May Expire Soon
In response to the COVID-19 pandemic, the U.S. Congress enacted legislation that temporarily allowed high deductible health plans (HDHPs) to provide benefits for telehealth services before plan deductibles were met. This relief became effective in 2020 and has been repeatedly extended. It currently applies to plan years beginning before Jan. 1, 2025.
Employers with HDHPs should review their health plan’s coverage of telehealth services to determine if changes should be made for the plan year beginning in 2025. Unless the relief is extended again, HDHPs must impose a deductible on telehealth services to be compatible with HSA contributions.
Also, any changes to telehealth coverage should be communicated to plan participants through an updated summary plan description or a summary of material modifications.
Compliance Overview – ACA Violations – Penalties and Excise Taxes
The Affordable Care Act (ACA) includes numerous reforms for group health plans and creates compliance obligations for employers and health plan sponsors. The ACA, for example, restricts health plans from imposing pre-existing condition exclusions and requires coverage for preventive care services without cost sharing. Some of the reforms for health plans apply to all health plans, while others apply only to non-grandfathered plans or to insured plans in the small group market
Compliance Overview – DOL’s Cybersecurity Program Best Practices for Plan Fiduciaries
The U.S. Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) has provided
guidance to assist plan fiduciaries and recordkeepers in their responsibilities to manage cybersecurity risks. According to EBSA, pension plans and health and welfare plans covered by the Employee Retirement Income Security Act of 1974 (ERISA) often hold millions of dollars or more in assets and store and/or transfer participants’ personally identifiable data, which can make them tempting targets for cybercriminals.
Compliance Bulletin – Mental Health Parity: New Comparative Analyses Requirements
On Sept. 9, 2024, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released a final rule to strengthen the requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA). The final rule focuses on nonquantitative treatment limitations (NQTLs) that health plans and health insurance issuers place on mental health and substance use disorder (MH/SUD) benefits.
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.
