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HIPAA Civil Penalties Decreased

 May 16 2019     Shelly Hodges-Konys and Diane Cross
It is rare to see “penalties decreased”, but here we have it and it is not a typo.  Late last month, the Department of Health and Human Services (HHS) released a notice applying a tiered annual limit to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) civil penalties.  The below is a summary of the new maximum penalties that all HHS HIPAA enforcement ac...

Final Notice of Benefit and Payment Parameters for 2020

 April 30 2019     Diane Cross
The Centers for Medicare & Medicaid Services (CMS) published its final Notice of Benefit and Payment Parameters for 2020 last week, which is issued annually and adopts changes for the next plan year.  This final rule primarily affects the individual market and the Exchanges, but also addresses various Affordable Care Act (ACA) provisions and related topics that impact employer-sponsored g...

Federal Judge Strikes Down Key Components of the DOL's Final Rule on Association Health Plans

 April 17 2019     Diane Cross
Recently, a federal judge invalidated two key provisions of the Department of Labor’s (DOL) final rule for Association Health Plans (AHPs).  Issued in 2018, the DOL’s final rule expanded the function of AHPs by allowing more small employers and individuals to join together and enroll in large group health insurance.  This provided small employers with a greater ability to gai...

Transition Policy Extended for Non-ACA Compliant Health Plans, Once Again

 April 8 2019     Diane Cross
Since 2013, the Department of Health and Human Services (HHS) has extended the transition policy for certain small employer health plans that do not comply with the Affordable Care Act (ACA). Per recent guidance from Centers for Medicare & Medicaid, health insurance issuers can renew non-ACA compliant coverage through 2020 for those plans that have so far avoided community rating and other ACA...

DOJ Supports the ACA Being Ruled Unconstitutional: Now What?

 March 27 2019     Diane Cross
The Department of Justice (DOJ) announced its support of the Texas v. Unites States ruling in a brief filed earlier this week, agreeing that the entire Affordable Care Act (ACA) is unconstitutional.  For background, a federal judge in Texas held in late 2018 that since the individual mandate penalty is eliminated, the entire ACA is unconstitutional (see ACA Ruled Unconstitutional: What’...

Employers' Ability to Recover Mistaken HSA Contributions

 March 18 2019     Diane Cross
Generally, contributions to an HSA are nonforfeitable (meaning contributions cannot be recouped once made).  But unfortunately, even with the best efforts, mistakes happen when administering HSA contributions.  To that end, IRS Notice 2008-59 provided welcomed guidance for employers and explained circumstances where an employer can recoup contributions made to an employee’s HSA, in...

How VA Medical Benefits Can Impact HSA Eligibility

 March 11 2019     Diane Cross
Because Health Savings Accounts (HSAs) provide such significant tax advantages, the IRS imposes strict eligibility requirements.  Generally, to be eligible for an HSA, an individual must: Be enrolled in a High Deductible Health Plan (HDHP); Not be covered by any disqualifying coverage; Not be enrolled in Medicare; and Not be eligible to be claimed as a dependent on ano...

ERISA's Summary Plan Description (SPD) Requirement - A Wrap Document Can Help

 February 28 2019     Diane Cross
The Employee Retirement Income Security Act (ERISA) sets minimum standards for employee benefit plans, providing several rules for private-sector employer sponsored group health plans (governmental and church plans are exempt from ERISA). Among ERISA’s many rules is the requirement to provide each participant with a Summary Plan Description (SPD). We often discover that many employers mista...

Medicare Part D Creditable Coverage Disclosure Due to CMS by March 1st

 February 8 2019     Diane Cross
It’s time again for many employers to disclose Medicare Part D Creditable Coverage status to the Centers for Medicare & Medicaid Services (CMS).  As a reminder, there are two disclosures required annually for certain employers related to Medicare Part D.  Employers with plans providing prescription drug coverage to individuals that are eligible for Medicare Part D must disclose...

Wellness Programs: Impact of the Vacated EEOC Wellness Incentive Maximum

 January 31 2019     Diane Cross
As mentioned in previous blog posts, most recently Wellness Program Incentives – Planning for 2019, the EEOC rule allowing a maximum wellness program penalty/incentive of 30% is vacated, effective since January 1, 2019. Since the rule has been vacated, we have received questions from employers curious if the other EEOC requirements still apply, as discussed below.  It is important to f...
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