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On Feb. 23, the Centers for Medicare and Medicaid Services put on public display final rules that require employer health plans to cover physician and hospital services in order to meet health care reform’s minimum value requirement. The rules also set the contribution self-insured health plans and insurers must make to a premium-stabilization fund for the individual […]
Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the Internal Revenue Service. IRS Notice 2015-17 reiterates IRS’ previous warning, in Notice 2013-54, that giving employees […]
Preparing employer benefit plans’ annual filings to federal agencies can be detailed and time-consuming. A review of recent changes to the 2014 Form 5500 series indicates this process could become even more laborious for some plans, as the government seeks more data disclosure. The Form 5500 is used by multiple government agencies (the U.S. Department […]
On Jan. 26, U.S. Supreme Court handed a victory to employers struggling to get retiree health care costs under control. A unanimous ruling in M&G Polymers USA v. Tackett, No. 13-1010 (Sup.Ct., Jan. 26, 2015), vacated the 6th U.S. Circuit Court of Appeals decision in Tackett. In doing so, the High Court criticized 6th Circuit […]
Implants — spinal fusion; as well as hip, knee and shoulder replacements — have emerged as major price problems today. Costs are up and so is utilization, which explains the cost surge health plans are undergoing for these procedures, according to three attorneys from The Phia Group in Braintree, Mass., who spoke in a Jan. […]
Employers have been shifting more premium costs to workers and increasing their deductibles. That, in addition to the fact that price growth in the health sector outpaces growth for the rest of the economy, has resulted in a disproportionate increase in employee out-of-pocket costs, a new Commonwealth Fund report says. Growth in health plan costs […]
Proposed changes to the Summary of Benefits and Coverage rules under health care reform include additions and subtractions to the SBC template, as well as clarifications on how plan sponsors and insurers may apportion the responsibility to furnish the SBC to participants. A third example would be added to the cost-sharing examples required in the […]
Leading employee benefits attorneys recently discussed rules on calculating workforces and identifying to whom the employer must make an offer of coverage. Vanessa Scott, a partner with Sutherland Asbill & Brennan, Washington, D.C., and Malcolm Slee, of Counsel at the Groom Law Group, Washington, D.C.,discussed the counting and measuring rules spawned by health care reform during […]
Employer contributions to a Section 125 cafeteria plan can be deducted from the employee’s cost of a health plan for purposes of determining the affordability of coverage, final IRS rules on minimum essential coverage published on Nov. 26 (79 Fed. Reg. 70464) stipulate. In order to be deducted, the café plan benefit must not be […]
Employers cannot simply give employees extra money to buy individual health insurance — whether through health reimbursement arrangements, health flexible spending arrangements or just plain cash — and expect to avoid “shared responsibility” penalties, the IRS with the U.S. Departments of Labor and Health and Human Services said in new frequently asked questions about the […]