Tag Archives: Employee Health & Welfare Plans

Changes to Employee Benefit Plans May Create Unforeseen Disclosure Deadlines

Believe it or not, it may be time to distribute a new Summary Plan Description (SPD) to include all changes made since the last issuance or a Summary of Material Modifications (SMM) for any amendments adopted during the 2018 plan year. The Rules:  The Department of Labor (DOL) regulations and Employee Retirement Income Security Act … Continue Reading

EIGHTH CIRCUIT RULES AGAINST THIRD PARTY ADMINISTRATOR IN CROSS-PLAN OFFSETTING IN GROUP HEALTH PLANS

 On January 15, 2019, the federal Eighth Circuit Court of Appeals issued its decision in Peterson v. UnitedHealth Group, Inc., 913 F.3d, 769 (8th Cir. 2019), in which the Court upheld the federal district court’s holding that UnitedHealth Group, Inc. (“United”) was not authorized to reduce (or “offset”) payments to medical providers under ERISA group … Continue Reading

IRS Announces Filing Extension for Furnishing 2018 Forms 1095-B and 1095-C and Continued Good Faith Transition Relief

In IRS Notice 2018-94, the IRS announced an extension for furnishing 2018 IRS Forms 1095-B (Health Coverage) and 1095-C (Employer-Provided Health Insurance Offer and Coverage), from January 31, 2019, to March 4, 2019.  The IRS issued this extension in response to requests by employers, insurers, and other providers of health insurance coverage that additional time … Continue Reading

IRS Reverses the $50 HSA Reduction for 2018

We recently informed you that the IRS reduced the 2018 health savings account (“HSA”) contribution limit for individuals with family coverage to $6,850.00 despite having previously announced that such limit was $6,900.  Because of compelling comments from stakeholders, the IRS reversed this decision in Revenue Procedure 2018-27 and the contribution limit for individuals with family … Continue Reading

IRS Reduces HSA Contribution Amount for Current Year

In 2017, the IRS released the 2018 inflation-adjusted figures for contributions to Health Savings Accounts (HSAs).  The contribution limits for HSAs associated with High Deductible Health Plans was increased to $3,450 for individuals with self-only coverage and to $6,900 for individuals with family coverage.  In December, the President signed the tax reform bill commonly known … Continue Reading

Health Savings Accounts Considerations for Employers

The health savings account (“HSA”) has become, since its creation in 2003, an increasingly popular option for employers to subsidize employee group health costs. Employees with HSAs can save money, on a tax-free basis, for medical expenses that aren’t otherwise covered. The account’s interest earnings and distributions (for qualified medical expenses) are also tax-free. The … Continue Reading

Premium Reimbursement Arrangements – Employers Beware

The Department of Labor (DOL) has just published a series of FAQs regarding premium reimbursement arrangements.  Specifically, the FAQs address the following arrangements: An arrangement in which an employer offers an employee cash to reimburse the purchase of an individual market policy. Where an employer provides cash reimbursement for the purchase of an individual market … Continue Reading

Affordable Care Act Employer Penalties – Another Reason to Make Sure Workers are Properly Classified as Employees or Independent Contractors

Beginning next year, an applicable large employer that does not offer affordable minimum value group health coverage to its fulltime employees (and their children up to age 26) will be vulnerable to employer shared responsibility penalties under Internal Revenue Code §4980H.  Whether an employer is an “applicable large employer” depends on its number of fulltime … Continue Reading

Employer Action Item – Health Care Reform

Under the Patient Protection and Affordable Care Act, beginning in 2015, certain large employers who do not offer affordable health insurance that provides minimum value to their full-time employees may be subject to significant penalties. Please refer to our article titled “Health Care Reform: Employers Should Prepare Now for 2015 to Avoid Penalties” for information … Continue Reading

IRS GUIDANCE: EMPLOYEE INCOME TAX CORRECTION FOR SAME-SEX SPOUSAL HEALTH COVERAGE AFTER UNITED STATES V. WINDSOR

  On June 27, 2014, the IRS released Information Letter 2014-0012, which contains guidance for employees who have had the value of same-sex spousal coverage under employer health plans — which until recently was required to be included in gross income — reported on their Forms W-2. BACKGROUND Historically, the employer cost of opposite-sex spousal … Continue Reading

EEOC Pregnancy Discrimination Enforcement Guidance Implicates Contraception Coverage Concerns

On July 14, 2014, the EEOC issued new Enforcement Guidance on Pregnancy Discrimination and Related Issues.  The immediately-effective Guidance sets forth the EEOC’s policies with regard to its enforcement of pregnancy-based employment discrimination prohibitions under Title VII — as clarified by the Pregnancy Discrimination Act of 1978 — and other federal laws. With regard to … Continue Reading

Health Care Reform Resource Center

We are pleased to announce the launch of Jackson Lewis’ Health Care Reform Resource Center. Our Resource Center provides one convenient place for you to obtain key health care reform-related law, agency guidance, Jackson Lewis articles and related information. We hope you find this resource helpful.… Continue Reading

New Rules Require Health Plans to Cover Women’s Contraception

Group health plans that are not grandfathered under the 2010 health care reform law (the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010) must provide women’s contraception without cost-sharing beginning with the first plan year that starts on or after August 1, 2012. The three agencies … Continue Reading

Continuing Health Coverage During Leaves of Absence, A Trap for the Unwary

It's fairly common for employers to continue benefits for employees out on leaves of absence. But what happens after protected leaves such as FMLA and USERRA end, or if the leave is not protected by law, and coverage continues? This post discusses a recent case where the carrier was able to back out of coverage because the plan terms simply did not support coverage during the leave, creating significant exposure for the employer.… Continue Reading

IRS Delays Enforcement of Health Care Reform Nondiscrimination Provisions for Insured Group Plans

The Internal Revenue Service has given a last-minute holiday gift to sponsors of insured group health plans.  It announced delayed enforcement for the new nondiscrimination provisions applicable to insured group health plans under the Patient Protection and Affordable Care Act of 2010 (as amended by the Health Care and Education Reconciliation Act of 2010; together … Continue Reading
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