Now, faced with an aging baby-boomer generation and increased costs related to disability litigation, the U.S. Department of Labor’s Employee Benefit Security Administration (DOL) has proposed new rules that would revise and strengthen the current rules for claims adjudication of disability claims under welfare and retirement plans.
The United States Supreme Court’s recent landmark rulings on same-sex marriage have significantly changed employers’ options and obligations with respect to benefit coverage for employees’ same-sex spouses and partners. Until recently, some employers voluntarily extended benefits to same-sex partners in recognition of the fact that same-sex couples had limited ability to marry. However, now that same-sex marriage is legal in all 50 states and recognized under federal law, employers must extend certain spousal benefits to same-sex spouses and can do so without additional administrative complexity. In addition, some employers are phasing out unmarried partner benefits by requiring partners to marry in order to be eligible for spousal benefit coverage.
Click to read the full article from Pension & Benefits Daily.
(c)2015 by The Bureau of National Affairs, Inc., reprinted with permission.
On September 29, 2015, the U.S. Department of Health and Human Services Office of the Inspector General (OIG), Office of Evaluation and Inspections, released two studies calling on the HHS Office for Civil Rights (OCR) to strengthen its efforts in both general enforcement of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Standards and enforcement of security breach reporting requirements. OIG commissioned both studies out of concern for the increased risk of an invasion of privacy and exposure to fraud, identity theft and other harm that patients face in an ever-expanding digital health environment.
On October, 30, 2015, the Equal Employment Opportunity Commission (EEOC) issued a proposed rule that would amend regulations implementing Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA), as they relate to employer wellness programs. Title II of GINA protects employees from employment discrimination based on their genetic information, including the health status of workers’ families.
On October 23, 2015, the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and Treasury issued frequently asked questions (FAQs) on the implementation of preventive care and wellness provisions of the Affordable Care Act (ACA) and mental health parity disclosure, adding to the existing list of 28 previous editions of FAQs on the implementation of ACA.
Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of the Fair Labor Standards Act (FLSA), added by the ACA, directed employers with more than 200 full time employees to automatically enroll new full time employees in one of the employer’s health benefits plans (subject to any waiting period authorized by law), and to continue the enrollment of current employees in a health benefits plan offered through the employer. This requirement, which had yet to take effect, was riddled with concerns and questions regarding how these employers would effectuate administration. The Budget Bill also sharply increased the amount of premiums employers pay to the Pension Benefit Guaranty Corporation, which will be detailed in a separate article.
The recently enacted Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 includes provisions that will extend the deadlines for filing future Form 5500 and Form 990 series information returns. In addition, the legislation modifies rules relating to the ability of veterans to participate in health savings accounts (HSAs), allows employers to disregard employees receiving certain veterans benefits when determining whether they are subject to the shared responsibility requirements of the Affordable Care Act (ACA), and further extends the ability of employers to use excess pension assets to pay for retiree health and group-term life insurance.
The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance policies and sponsors of self-insured health plans. The fees are calculated using the average number of lives covered under the policy or plan, and the applicable dollar amount for that policy or plan year.
The Internal Revenue Service (IRS) recently announced the cost-of-living adjustments to the applicable dollar limits for various employer-sponsored retirement and welfare plans for 2016. Although some of the dollar limits currently in effect for 2015 will change, the majority of the limits will remain unchanged for 2016.
On-site clinics can be a valuable addition to an employer’s overall health care strategy with respect to promoting prevention, improving quality outcomes and reducing the employer’s overall trend in health care spending. However, given the myriad laws that apply to such clinics, an employer is well-advised to develop a comprehensive legal compliance strategy in designing and implementing the structure and operation of its onsite clinic.
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