Health and Welfare Plans Archives - Page 60 of 129

Affordable Care Act Compliance: IRS Releases Draft 2016 Employer Reporting Forms and Instructions

by McDermott Will & Emery | Aug 30, 2016 | Health and Welfare Plans

On August 2, the Internal Revenue Service (IRS) released revised draft Forms 1094-C and 1095-C, and draft instructions for completing these forms for the 2016 reporting year (see here). Although these are not final versions, it is important for employers to review the updates and changes from the 2015 forms and instructions as they prepare for the 2016 filings.

The Affordable Care Act (ACA) created new reporting requirements under Sections 6055 and 6056 of the Internal Revenue Code (Code). The new rules require an applicable large employer (ALE) to report, on IRS Forms 1094-C and 1095-C, information about offers of health insurance coverage to full-time employees (FTEs) and the provision of minimum essential coverage (MEC). The Form 1094-C is also referred to as the “authoritative transmittal.” For 2016, an ALE is generally an employer with 50 or more FTE equivalents. Under Code Section 6056, an ALE must annually file with the IRS a report listing the offers of coverage made to its FTEs during the reporting year. In addition, ALEs must furnish a related statement of coverage information to FTEs. Under Code Section 6055, employers (including ALEs) who provide MEC under self-insured plans must also report MEC information for each individual covered under the employer’s self-insured plan. ALE status is determined on a controlled group basis, and each member of the controlled group is an “ALE Member” with an independent responsibility to file a Form 1094-C and Form 1095-Cs. Generally, the reporting is required at the employer identification number (EIN) level.

Under Code Section 6055, employers that are not ALEs must report MEC information on Forms 1094-B and 1095-B. Although these forms were also revised recently, draft instructions for completing these forms have not yet been released.

Read the full article here for the upcoming changes in detail, when to file and next steps to plan for.

Michigan Health Insurance Claims Assessment Act is Not Preempted by ERISA

by McDermott Will & Emery | Aug 23, 2016 | Health and Welfare Plans

The Sixth Circuit, has decided, on remand from the Supreme Court, that the Michigan Health Insurance Claims Assessment Act (Act) is not preempted by ERISA. The Act imposes a 1 percent tax on all paid claims by insurers or third party administrators (TPAs) for health services rendered in Michigan to Michigan residents. The case was brought by the Self-Insurance Institute of America (SIIA), a trade association representing the sponsors of self-insured health plans and their TPAs, alleging the Act was preempted by ERISA. The trial court dismissed the case, concluding that the law was not preempted by ERISA. The Sixth Circuit also held that the Act was not preempted. After granting certiorari, the Supreme Court vacated this judgment and remanded the case to the Sixth Circuit for further consideration in light of the Supreme Court’s decision in Gobeille v. Liberty Mut. Life Ins. Co., which invalidated a Vermont statute that required an ERISA plan to report health care information to an all-payer claims database, since the Vermont law interfered with nationally uniform plan administration. On remand, the Sixth Circuit reaffirmed its original decision, finding that nothing in Gobeille warranted overturning its decision.

HIPAA Privacy and Security Compliance for Group Health Plan Sponsors

by McDermott Will & Emery | Aug 18, 2016 | Health and Welfare Plans, Privacy and Data Security

Joanna Kerpen authored an article on final HIPAA rules for privacy enforcement and audit programs, particularly those with additional requirements aimed at group health plan sponsors. This report focuses on the final regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), in January 2013, HIPAA enforcement and audit programs, HIPAA-related additional requirements of group health plan sponsors, and the actions that must be taken by group health plan sponsors to ensure compliance with the final regulations and requirements and to prepare for potential audits and enforcement actions.

“The final HIPAA regulations made many changes to the existing HIPAA privacy and security rules that are applicable to covered entities,” Ms. Kerpen wrote, and she urged plan sponsors to conduct a comprehensive review of their compliance plans to prepare for audits or enforcement action.

Read the full article here.

Proposed Changes to Form 5500 Would Significantly Increase Reporting Obligations for Health and Welfare Plan Sponsors

by Joseph K. Urwitz and Megan Mardy | Aug 16, 2016 | Health and Welfare Plans

On July 11, 2016, the Department of Labor (DOL) and Internal Revenue Service (IRS) announced a proposal to implement significant changes to the forms and regulations that govern annual employee benefit plan reporting on Form 5500. The proposed changes, which were published in the Federal Register on July 21, 2016, would considerably increase the annual reporting obligations for nearly all health and welfare plans. The changes would also have a considerable impact on annual retirement plan reporting obligations. For more information about the effect of the proposed changes on retirement plan sponsors, see Proposed Changes to Form 5500 Reporting Requirements May Have Significant Impact on Retirement Plan Sponsors.

The DOL is seeking written comments on the proposed changes, which must be provided by October 4, 2016. The revised reporting requirements, if adopted, generally would apply for plan years beginning on and after January 1, 2019.

Read the full article here.

Proposed Changes to Form 5500 Reporting Requirements May Have Significant Impact on Retirement Plan Sponsors

by Joseph K. Urwitz, Megan Mardy and Sarah L. Engle | Aug 11, 2016 | Health and Welfare Plans, Retirement Plans

On July 11, 2016, the Department of Labor (DOL), Internal Revenue Service (IRS) and Pension Benefit Guaranty Corporation (PBGC) announced a proposal to implement sweeping changes to the forms and regulations that govern annual employee benefit plan reporting on Form 5500. The proposed changes, which were published in the Federal Register on July 21, 2016, would significantly increase the annual reporting obligations for nearly all retirement plans. The changes also would have a considerable impact on employer-sponsored group health plans. For more information about the effect of the proposed changes on health and welfare plan sponsors, see Proposed Changes to Form 5500 Would Significantly Increase Reporting Obligations for Health and Welfare Plan Sponsors.

The DOL is seeking written comments on the proposed changes, which must be provided by October 4, 2016. The revised reporting requirements, if adopted, generally would apply for plan years beginning on and after January 1, 2019. Certain compliance questions will, however, be effective for Form 5500 series returns filed for the 2016 plan year.

Read the full article here.

DOL Significantly Increases Some Penalties for ERISA Violations

by Alan D. Nesburg, PC and Diane Morgenthaler | Jul 26, 2016 | Health and Welfare Plans, Retirement Plans

The US Department of Labor increased the penalties for specified violations of the Employee Income Retirement Security Act of 1974. Most of the penalty increases involve reporting and disclosure failures related to benefit plans and will be effective for penalties assessed after August 1, 2016, if the violation occurred after November 1, 2015.

Under the Federal Civil Monetary Penalties Inflation Adjustment Act Improvements Act of 2015 (2015 Inflation Adjustment Act), the US Department of Labor (DOL) increased the penalties for specified violations of the Employee Income Retirement Security Act of 1974 (ERISA), published in an interim final rule (IFR). Most of the penalty increases involve reporting and disclosure failures related to benefit plans. After the 45-day comment period on the IFR lapses, the DOL will publish final regulations.

Penalty Adjustments for Inflation

The IFR adjusts ERISA reporting and disclosure penalties for inflation. The IFR’s adjustments apply only to penalties assessed after August 1, 2016, if the violation occurred after November 2, 2015. If the violation occurred on or before November 2, 2015, the current penalty amounts apply.

Annual Penalty Adjustments for Inflation

The 2015 Inflation Adjustment Act directs the DOL to adjust penalties annually for inflation. Beginning in 2017, DOL will adjust penalty amounts no later than January 15 of each year. By January 15, 2017, DOL will adjust penalty amounts to reflect any increase in inflation that occurred between October 2015 and October 2016. Future annual inflation adjustments are not subject to regulatory notice and rulemaking requirements. The DOL will post any changes to penalty amounts on its website.

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Same-Sex Marriage Is Legal in All 50 States: So What Now?

by Todd Solomon | Jul 21, 2016 | Benefit Controversies, Employment, Health and Welfare Plans, Retirement Plans

Now that same-sex marriage is legal in all 50 states, most benefits plans will treat same-sex spouses the same as opposite-sex spouses. But several tricky issues remain. For example, what if an employer with religious beliefs wants to continue to exclude same-sex spouses from receiving benefits under its retirement plans? Or its medical and dental plans? Are employers that deny coverage vulnerable to sexual orientation and/or sex discrimination lawsuits under state and local law or to federal Title VII lawsuits? What has the EEOC said about this issue? In addition, should employers consider dropping benefits for unmarried partners? Is the answer different if the employer’s plans cover both same-sex and unmarried opposite-sex partners?

The following presentation highlights some of these considerations.

View presentation slides.

Integration of Technology Into Health Care Delivery

by Dale C. Van Demark and Lisa Schmitz Mazur | Jul 19, 2016 | Health and Welfare Plans, Privacy and Data Security

The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care industry envision delivery models rivaling those imagined by celebrated science fiction authors, and claim that the integration of information technology into even the most basic health care delivery functions can reduce cost, increase access, improve quality and, in some instances, fundamentally change the way health care is delivered.

These visions are difficult to refute in the abstract; the technology exists or is being developed to achieve what just a few years ago seemed the idle speculation of futurists. But delivering this vision in an industry as regulated as health care is significantly harder than it may seem. While digital health models have existed for many years, the regulatory and reimbursement environment have stifled their evolution into fully integrated components of the health care delivery system.

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New York and San Francisco Approve Mandatory Paid Family Leave

by McDermott Will & Emery and Ruth Wimer | Jul 14, 2016 | Employment, Health and Welfare Plans, Labor

Both the State of New York and the City of San Francisco recently granted paid family leave to eligible employees. Paid family leave becomes effective on January 1, 2017, in San Francisco and on January 1, 2018, in New York.

Read the full article.

New Mental Health Parity and Addiction Equity Act Guidance from the DOL

by McDermott Will & Emery | Jun 28, 2016 | Health and Welfare Plans, Labor, Mental Health Parity and Addiction Equity Act

The US Department of Labor (DOL) has provided guidance on health plan provisions that could trigger a violation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act. The DOL provided particular examples broken down by categories of plan provisions relating to coverage of mental health (MH)/substance use disorder (SUD) benefits which should trigger careful analysis of coverage for medical (med)/surgical med/surg) benefits to ensure compliance with the MHPAEA’s provisions regarding parity of non-quantitative treatment.

Read the full article.

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