Employers

Posted April 26th, 2023 in Employers

Cafeteria Plans, sometimes called Premium-only-Plans (POPs) or Section 125 Plans, allow employees to pay for health and welfare benefits with pre-tax contributions. Because contributions are tax-deductible, the Internal Revenue Service (IRS) has a set of rules in place to ensure highly compensated employees are not eligible for benefits more favorably than non-highly compensated employees. This is referred to as the Eligibility Non-Discrimination Test.
 

Posted March 23rd, 2023 in Employers

Applicable Large Employers (ALEs) are those who employed 50 or more full-time equivalent employees in the previous calendar year. Under the Affordable Care Act (ACA) law, ALEs must offer minimum essential coverage to at least 95% of its full-time employees or they risk penalties. ALEs who fail to meet this offer requirement risk a significant penalty if just one full-time employee receives a subsidized individual health insurance plan through a Marketplace.
 

Posted March 15th, 2023 in Employers

On February 21, 2023, the Internal Revenue Service (IRS) published a final rule which changes the electronic filing requirements for Forms 1094-B, 1095-B, 1094-C, and 1095-C.

Posted March 1st, 2023 in Employers

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees to offer continuation coverage under a group health plan for periods of 18, 29 or 36 months depending on the qualifying event. Qualifying events generally include a loss of coverage due to 1) termination of employment, 2) a reduction in hours, 3) an employee’s entitlement to Medicare, 4) death of the employee, 5) divorce or legal separation from the employee, and 6) a dependent child reaching the maximum age limit to be covered under the plan.

Posted January 12th, 2023 in Employers

The COVID-19 national public health emergency is set to expire on January 11, 2023; however, the Biden administration is expected to issue another extension of the national public health emergency. It is unknown at this time when the national public health emergency will be declared over.

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Posted December 14th, 2022 in Employers

Annual Medicare Part D reporting is required for all employers who provide health benefits with prescription drug coverage. The reporting is an online filing to the Centers for Medicare & Medicaid Services (CMS), and it lets CMS know if the prescription drug coverage available on the employer’s health plan is “creditable.”

Posted December 7th, 2022 in Employers

The Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices. PCORI is funded in part by fees which are charged to health plans.

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Posted October 13th, 2022 in Employers

Last year, the State of Illinois passed a law called the Consumer Coverage Disclosure Act (CCDA). The CCDA requires a written disclosure to be provided by every employer who has employees in the State of Illinois and who also provides group health insurance coverage to those employees.

Posted October 4th, 2022 in Employers, Producers

On September 27, 2022, the Centers for Medicare & Medicaid Services released the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2023 Medicare Part D income-related monthly adjustment amounts. Below is a summary of those numbers:

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