DOWNLOAD PDF JULY 2019 COMPLIANCE UPDATE PCORI FEE DUE JULY 31st The PCORI fee is part of the Affordable Care Act to help fund patient-centered outcomes research that addresses a variety of high priority conditions and topics. It is assessed against all health plans. If you sponsor a fully insured health plan, the carrier reports and pays the fee. However, if you sponsor a self-funded health plan, an HRA, then you must report... Read More
DOWNLOAD PDF JUNE 2019 COMPLIANCE UPDATE PCORI FEE COMING DUE If you sponsor a self funded health plan (including just an HRA) you have to remit the PCORI Fee to the IRS by July 31, 2019. PCORI FEE DUE JULY 31 PCORI FILING DUE TO IRS BY JULY 31 The fee is reported on IRS Form 720 and is paid with IRS Form 720V. If you are sponsoring a... Read More
DOWNLOAD PDF MAY 2019 COMPLIANCE UPDATE NEW DRUG TV ADVERTISING RULES COMING Beginning in July, the Trump administration is requiring drug manufacturers, when they advertise on television, to list the cost of the drugs covered by Medicare or Medicaid, if the drug’s monthly cost is more than $35. HHS RULE REQUIRES MANUFACTURERS TO DISCLOSE DRUG PRICES Plan sponsors should expect that the plan participants may start to question how the costs of drugs impact them. ... Read More
DOWNLOAD PDF APRIL 2019 COMPLIANCE UPDATE WHEN DOES THE “CLOCK” START? The ERISA claims procedures require claimants to follow certain timelines when appealing an adverse ruling. ERISA Administrative Appeal Barred As Untimely This court case held that the “clock” starts on the date the plaintiff got notice that her benefits were going to terminate; not on the date the benefits were actually terminated. Complying with the timelines is important and failure to comply can... Read More
DOWNLOAD PDF MARCH 2019 COMPLIANCE UPDATE Contract Theory Governs Retiree Health Coverage Health coverage is expensive and employers are having a hard time offering quality/affordable coverage to employees. Therefore, it comes as no surprise that employers often want to reduce or eliminate coverage for retirees. COURT APPLIES ORDINARY PRINCIPALS OF CONTRACT LAW FOR BARGAIN AGREEMENTS SIXTH COURT RULES FOR EMPLOYER TO TERM RETIREE COVERAGE It also should come as no surprise the retirees will... Read More
DOWNLOAD PDF FEBRUARY 2019 COMPLIANCE UPDATE As the government re-opens its doors, it appears it is making tax changes with a vengeance. Please take a minute to read this month’s newsletter for some important changes that have come across Capitol Hill, along with other rulings that may affect you as an employer or employee. Don’t Use My Money!! A recent Federal court case prohibited United HealthCare from using money from one health plan to offset... Read More
DOWNLOAD PDF We hope everyone had a safe and happy holiday season. Time to get back to work unless you are impacted by the government shutdown. No telling when that will end. This newsletter will be longer than most since it includes articles from the date of the last newsletter (i.e. November 15, 2018) till today. PLAN LIMITS FOR 2019 Many of the rules of government benefit plans have an inflationary factor. That is, the... Read More
DOWNLOAD PDF HOLIDAY SEASON GIFT IDEAS Just in time for the gift giving season I am pleased to announce the 2018/2019 Edition of my book, the Welfare Benefits Guide: Health Plans and Other Employer Sponsored Benefits, is now available. 2018-2019 Welfare Benefits Guide This makes the perfect stocking stuffer and we are adding a new twist. If you buy at least 10 sets of my book, I will autograph each one for a nominal fee.... Read More
DOWNLOAD PDF MEDICARE PART D NOTICES There are two Medicare Part D Notice requirements. Medicare Part D is the prescription drug benefits under Medicare. There are two notices. One goes to the employees and the other goes to the government. There is some confusion regarding the notices to employees. Everyone says this notice has to be distributed by October 15, which is the start of the annual open enrollment period. However, the rules say the... Read More
DOWNLOAD PDF LEGAL FEES UNDER ERISA LITIGATION No one likes to be involved in a lawsuit except the lawyers. Oftentimes lawyers will take on a case because the statute allows for legal fees. ERISA is one of those laws. ERISA allows fees for “some success” The courts have expanded the circumstances under which lawyers can be awarded fees when the basis of the lawsuit is ERISA. The standard is now that the court may award... Read More