Health and Welfare Plans

Join us Friday, December 7 for our monthly Fridays With Benefits webinar. New proposed rules make the HRA an interesting option for employers beginning in 2020. Join McDermott lawyers for an interactive discussion regarding the “Integrated HRA” the “Excepted Benefit HRA” and the medical plan design opportunities they present.

Join our lively 45-minute discussion while we tackle the following items:

  • Can we really get out of the medical coverage game?
  • How does the Integrated HRA work?
  • What are the next steps?

Friday, December 7, 2018
10:00 – 10:45 am PDT
11:00 – 11:45 am MDT
12:00 – 12:45 pm CDT
1:00 – 1:45 pm EDT

Register now.

Yesterday, the IRS released Notice 2018-94. This notice extends the due date for furnishing to individuals the 2018 Form 1095-B, Health Coverage, and the 2018 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage from January 31, 2019 to March 4, 2019. Note that the 1095-C reporting to the IRS has not been extended. The deadline for filing to the IRS is February 28, 2019 (if not filing electronically) or April 1, 2019, if filing electronically. This notice also extends good-faith transition relief from reporting penalties for 2018.

Any employer who has six or more employees in Massachusetts in any calendar month after November 2017 is required to complete a Health Insurance Responsibility Disclosure (HIRD) form by November 30, 2018. The HIRD form is used by MassHealth to collect information about employer-sponsored insurance offerings. The Massachusetts Department of Revenue recently published a set of FAQs stating that the HIRD form:

  • Is filed by an employer through the employer’s MassTaxConnect web portal (the employer clicks the “File health insurance responsibility disclosure” link to access the form);
  • May be filed by an employer’s third-party payroll provider on the employer’s behalf, though it is the employer’s responsibility to make sure the form is timely filed;
  • Will not be used to impose fines or penalties related to the employer’s insurance offerings;
  • Must be filed annually by November 30 in future years; and
  • Does not require employees to complete a separate form. Employers may recall that a prior version of the HIRD form which was discontinued in 2014 required both the employer and the employee to complete forms.

The FAQs do not specifically establish a penalty for failing to meet the annual November 30 deadline. There is also a possibility that a court could determine that the Employee Retirement Income Security Act of 1974 preempts the HIRD requirement, meaning that employers would no longer be required to file the form if the requirement were challenged in court. However, we recommend employers submit the HIRD form by the fast-approaching deadline on November 30, 2018.

President Trump signed an executive order last year directing the Secretaries of Labor, Treasury and Health and Human Services to consider proposing regulations to “increase the usability of HRAs.” This month, the collective departments issued proposed regulations containing changes to the prohibition on pairing HRAs with individual health policies, as well as other changes to the current HRA rules.

Proposed effective date January 1, 2020; comments due December 28, 2018.

Access the full article.

During the Tax in the City event held in Dallas, Erin Turley and Allison Wilkerson gave an overview of benefit plan audits and the IRS examination process. They discussed various areas of focus, including, required minimum distributions, investment issues, benefit calculations and appropriate tax reporting. They provided attendees with best practices before an audit, as well as helpful resources from the IRS and DOL.

View the full presentation.

On October 10, 2018 President Trump signed two bills that ban “gag clauses” in pharmacy contracts. Congress passed the two bills—one for Medicare prescription drug plans (“Know the Lowest Price Act”) that will go into effect in January 2020, and another for commercial employer-based and individual policies (“Patient Right to Know Drug Prices Act”) effective immediately—by almost unanimous vote in September 2018.

While many states have already prohibited the use of these clauses, this is the first such action on a federal level.

Gag clauses are sometimes found in contracts between pharmacies and insurance companies, pharmacy benefit managers or group health plans and bar pharmacists from telling customers that they could save money by paying cash for their prescriptions rather than using their health insurance. If pharmacists violate the gag rule, they risk penalties and/or contract termination. Under the new legislation, pharmacists are not required to tell patients about the lower cost option, but they also cannot be contractually prohibited from engaging in the cost conversation.

The legislation is consistent with the position of the Centers for Medicare & Medicaid Services (CMS), which, in May of this year, issued guidance stating that “gag clauses” are unacceptable in the Medicare Part D program.

Originally published in the Health & Life Sciences News blog.

The Internal Revenue Service and the Security Summit partners recently issued a news release outlining the “Security Six,” a list of essential steps to protect stored employee information on networks and computers. Employee benefits professionals, including those who administer welfare and retirement plans for employees and beneficiaries, should review and implement the “Security Six” in order to protect sensitive data from cyberattacks.

Access the full article.

We would also like to thank law clerk Charnae Supplee for contributing to this article.