READ TIME: 7 MINUTES June saw the Supreme Court uphold and affirm the authority of the Department of Health and Human Services (HHS) to appoint and oversee members of the body that evaluates and recommends preventive treatments as part of the Affordable Care Act. Employers can review their options should they receive a medical loss […]
Read moreCategory: Compliance Alert
New Federal Data Sharing Deals Heighten Compliance Risks for Plan Sponsors
READ TIME: 5 MINUTES Recent federal changes are reshaping the way immigration enforcement intersects employment issues, posing new compliance risks for employers and plan sponsors. Two recent developments ramped up coordination among government agencies, including the Internal Revenue Service, to detect and deter unauthorized work and benefits, and shed light on what employers need to […]
Read moreMay 2025 Compliance Recap
In May, applicable large employers were focused on RxDC reporting, due in June, and the PCORI filing, due in July. The U.S. Departments of Labor, Health and Human Services, and the Treasury jointly announced a pause in enforcement of the 2024 Final Rule implementing the Mental Health Parity and Addiction Equity Act (MHPAEA), and a […]
Read moreNew CMS Rules on Medicare Reporting Penalties
READ TIME: 6 MINUTES The Centers for Medicare & Medicaid Services (CMS) recently issued final rules outlining the penalties for responsible reporting entities (RREs) that fail to meet Medicare Secondary Payer (MSP) reporting obligations. The regulations were applicable as of October 11, 2024, and enforcement will begin in October 2025. The penalties for non-compliance are […]
Read moreSeptember 2024 Compliance Recap
READ TIME: 7 MINUTES September brought the due date for the Summary Annual Report, which summarizes the Form 5500 contents. Employers prepared to send out the required Medicare Part D Creditable Coverage letters to eligible participants and enrolled beneficiaries. The Departments released final rules on the MHPAEA NQTL analysis. California insurers are required to cover […]
Read moreAugust 2024 Compliance Recap
READ TIME: 7 MINUTES In August, the FTC ban on non-compete agreements was struck down by a court stating that the FTC did not have the power to implement the ban and that its application was too broad. The FDA approved new and updated COVID-19 vaccines for adults and children as part of the preventive […]
Read moreJuly 2024 Compliance Recap
July was a busy month for sponsors of group health plans. The final DOL rule on overtime exemption requirements went into effect July 1. IRS Form 5500, due on July 31 for calendar year plans, applies to most public and private sector businesses providing plans to 100 or more participants. Also due by July 31 […]
Read moreEmployee Classifications Guide for Group Health Plans
READ TIME: 10 MINUTES It is essential for an employer to correctly classify workers as employees or independent contractors for it to comply with federal, state, and local laws. Misclassifying employees can have significant financial and legal consequences for employers, leaving them open to liability for unpaid overtime pay, payroll taxes, unpaid benefits, for example. […]
Read moreUpcoming Changes for HDHP Plan Sponsors under Medicare Part D
READ TIME: 8 MINUTES Employers who sponsor group health plans must act now regarding the status of their prescription drug coverage in advance of changes to Medicare Part D that go into effect for 2025. The Inflation Reduction Act of 2022 (IRA) made changes to Medicare Part D to enhance benefits and enrollee cost savings, […]
Read moreEmployers May Face New Challenges with IVF Coverage after Alabama Decision
READ TIME: 4 MINUTES Plan sponsors have been faced with challenges for the nearly two years since the Supreme Court issued its decision in Dobbs v. Jackson Women’s Health Organization, which overturned federal abortion protections established by Roe v. Wade. The Dobbs decision caused many employers to reconsider the types of reproductive care they would […]
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