HEALTH REFORM

HEALTH REFORM

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 ...

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 ...

Compliance Recap | December 2023

December provided employers an opportunity to review year-end compliance to prepare for the new year. Employers confirmed that their worksite posters are appropriate for the type of business, number of employees, and state, and are the most recent version. Employers who are applicable large ...

Compliance Recap | November 2023

November brought an ACA FAQ from the Departments of Labor, Health and Human Services, and the Treasury ensuring that SBCs and claims and appeals notices are available when more than 10 percent of the population is literate only in a specific non-English language. UnitedHealth’s pharmacy benefit ...

Compliance Recap | October 2023

October saw the release of adjusted civil penalties for HIPAA violations, ACA requirements, and Medicare Secondary Payer rules. Health plan limits and maximums for 2024 including high deductible health plans (HDHPs), health savings accounts (HSAs) flexible spending accounts (FSAs), and ...

Compliance Recap | September 2023 

In September, plan sponsors began sending out Medicare Part D Creditable Coverage notices, and both Oregon and Maine announced Paid Family and Medical Leave laws. Sponsors of group health plans began completing the required Gag Clause Attestation due by the end of 2023. The Departments of ...

Compliance Recap | August 2023

In August, the IRS announced a decrease in the ACA affordability percentage to 8.39%. Both Colorado and Illinois expanded their leave laws. The Department of Labor released its updated version of the Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) Notice. ...

Compliance Recap | July 2023

July saw two proposed rules, one focusing on short-term, limited-duration health plans, and one addressing provider networks and data collection for the Mental Health Parity and Addiction Equity Act (MHPAEA). The PCORI fee was due on July 31 for plan sponsors of self-insured groups and HRAs. ...

Compliance Recap | June 2023

June is preparation time for employers with self-funded plans and HRAs. The Patient-Centered Outcomes Research Institute (PCORI) fee will be due for those plans on July 31. Self-insured non-federal governmental health plans can no longer opt out of the MHPAEA, and COVID-19 Form I-9 ...

Compliance Recap | May 2023

May brought a reminder memo from the IRS on claims substantiation and payment of medical and dependent care expenses, and an update for the 2024 HDHPs, HSAs, and Excepted Benefit HRA limits. The Departments of Labor, Health and Human Services, and the Treasury issued an FAQ on the Braidwood ...

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