compliance

compliance

CMS Updates Simplified Method for Determining Creditable Coverage Status for 2026

This month, the Centers for Medicare and Medicaid Services (CMS) announced final instructions for the changes to Medicare Part D prescription drug coverage mandated by the Inflation Reduction Act of 2022 (IRA) which will affect employer-sponsored plans in 2026. The changes are intended to ...

Compliance Recap | March 2025

In March, employers submitted their electronic filings to the Internal Revenue Service for the Affordable Care Act reporting requirement. Medicare Part D disclosure to CMS, certain reporting on HIPAA breaches, and MEWA Form M-1 were due in March. ACA Reporting Affordable Care Act (ACA) ...

2025 Penalties for Health and Welfare Plans

In January, the Department of Labor (DOL) published the inflation-adjusted penalties for ERISA violations in 2025. The following table summarizes the new penalty amounts and reminds employers of filing deadlines to avoid incurring penalties. Employer Action Items Prepare for annual filing or ...

2025 RxDC Reporting Deadline

Since the passage of Section 204 of the Consolidated Appropriations Act, 2021 (CAA), referred to as the No Surprises Act (NSA), employers have been required to submit annual prescription drug and health care spending data with the Prescription Drug Data Collection (RxDC) report. The RxDC report ...

Compliance Recap | February 2025

The federal government in 2025 is experiencing significant internal restructuring, workforce reductions, and communication restrictions across various departments. The results from the Departments of Labor and Health and Human Services investigations into Mental Health Parity and Addiction ...

Compliance Alert | CMS RxDC Submission Required

To comply with the legislation to report on pharmacy information under the Consolidated Appropriations Act, you are required to submit premium information to the Centers for Medicare & Medicaid Services (CMS) by June 1, 2025. You should be receiving an email or an online portal alert to ...

Compliance Recap | January 2025

January brought guidance on the management of taxes on state paid family and medical leave, and an update on the much-watched Johnson & Johnson fiduciary lawsuit. The Department of Health and Human Services provided the 2025 Federal Poverty Levels and FAQs clarify gag clause prohibitions ...

New ACA Reporting Rules

The Employer Reporting Improvement Act (ERIA), outlined in a recent Compliance Advisor, and the Paperwork Burden Reduction Act (PBRA) were signed into law by President Biden. Together, the new laws ease the burdens of furnishing copies of IRS Forms 1095-B and 1095-C to applicable individuals ...

Rising ERISA Class-Action Lawsuits Over Tobacco Surcharges in Health Plans

A wave of ERISA class-action lawsuits is challenging tobacco surcharge programs in employer-sponsored health plans across the U.S. These cases center on potential fiduciary breaches, with plaintiffs arguing that surcharges added to tobacco users’ premiums are not compliant with federal laws ...

Compliance Alert | ACA Reporting Obligations, Deadlines & Updates

Do you have a plan for meeting your ACA Reporting obligation?  At a time when IRS ACA penalties are increasing, paper filing is disappearing and submissions are getting more complex, the urgency for timely and compliant filing is more important than ever. ACA Reporting Services Do you have a ...

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