compliance

compliance

Frequently Asked Questions about the Patient-Centered Outcomes Research Institute (PCORI) Fee

Updated May 2024 Q1: What plans does the PCORI fee apply to? A1: All plans that provide medical coverage to employees owe this fee. Medical coverage includes preferred provider (PPO) plans, health maintenance organization (HMO) plans, point-of-service (POS) plans, high deductible health plans ...

IRS Releases 2025 Limits for HDHPs and HSAs

The IRS recently issued Revenue Procedure 2024-25 to announce the 2025 inflation-adjusted amounts that apply to health savings accounts (HSAs), excepted benefit health reimbursement arrangements (EBHRAs), and high-deductible health plans (HDHPs). The newly announced figures result in increases ...

HHS Finalizes Section 1557 Nondiscrimination Regulations under the Affordable Care Act

The Office of Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) together with the Centers for Medicare and Medicaid Services (CMS) released regulations under Section 1557 of the Affordable Care Act (the “Final Rule”) on April 26, 2024. These final regulations follow ...

Compliance Recap | April 2024

In April, a ban went into effect for most non-compete clauses, and the Centers for Medicare and Medicaid Services (CMS) portal opened for RxDC reporting submissions due June 1, 2024. The Equal Employment Opportunity Commission (EEOC) released final regulations mandating how employers with 15 or ...

Compliance Recap | March 2024

ACA reporting is in its first year of the required electronic reporting for employers filing ten or more returns annually. Employers and employees must make changes to HSAs by the April 15 deadline. Employers of all sizes continued to prepare for the June 1 RxDC Reporting using the newly ...

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, 2024. You should be receiving an email or an online portal alert to ...

DOL Announces 2024 Penalties for Health & Welfare Plan Compliance Errors

Since 2015, federal agencies have been required to annually review the laws and regulations they enforce to adjust applicable penalties for inflation. These adjustments, or so the theory goes, provide higher incentives for plan sponsors to ensure their benefit plans and programs remain ...

Compliance Recap | February 2024

February saw a potential industry-changing lawsuit against Johnson & Johnson and its plan fiduciaries asserting a breach of fiduciary duties and mismanagement of Johnson & Johnson’s prescription drug benefits program, costing its ERISA plans and employees millions of dollars in the form ...

HHS Releases Updated Drug Data Collection (RxDC) Reporting Instructions

Under Section 204 of the Consolidated Appropriations Act, 2021 (CAA), referred to as “The No Surprises Act” (NSA), all employer-sponsored health plans must satisfy certain transparency requirements by reporting annual prescription drug and health care spending data (often referred to as the ...

Compliance Recap | January 2024

January was a relatively quiet month on the employee benefits compliance front. The Wage and Hour Division of the Department of Labor (DOL) introduced a new rule laying out the guidelines employers can follow to determine how to classify workers. The DOL also released Part 64 of its FAQs about ...

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