On October 2, 2020, the IRS issued Notice 2020-76, which provides:
An extension of time, until March 2, 2021, for employers to provide Forms 1095-C to their full-time employees and other individuals; and
A final extension of relief from penalties for the 2020 reporting year for employers and other entities that make good-faith efforts to comply with the reporting requirements.
Employees have an extended timeframe to, in part, elect COBRA, make COBRA payments, add dependents, and appeal denials of benefits. As the timeframe may extend beyond the current plan year, in some cases with coverage going into effect retroactively for many months, there are concerns about what gaps in insurance coverage there could be. This may particularly be an issue with stop loss insurance.
Read MoreAs a reminder, insurance carriers are required to satisfy certain medical loss ratio (“MLR”) thresholds. This generally means that for every dollar of premium a carrier collects with respect to a major medical plan; it should spend 85 cents in the large group market (80 cents in the small group market) on medical care and activities to improve health care quality. If these thresholds are not satisfied, rebates are available to employers in the form of a premium credit or check.
Read MoreOn March 1, 2019, New Jersey established a transit benefit ordinance that requires employers to offer employees pre-tax commuter transit benefits, consistent with certain qualified transportation fringe benefits, as defined in Section 132(f) of the Internal Revenue Code.
Read MoreSchulman Insurance has skillfully adapted our usual procedures to conform to the “new normal” of a world struck by the COVID-19 pandemic. Many employers have faced the issue of how to handle benefits renewals when social distancing measures and limits on the number of people gathering have been implemented. Historically, we have held benefits presentations in-person, allowing employees to engage with our brokers in real time. However, for the safety of all, we have had to adjust our usual practices.
Read MoreSix weeks after a federal district court vacated four provisions in the Families First Coronavirus Response Act (“FFCRA”) temporary regulations, the Department of Labor (“DOL”) has responded by reaffirming two of those provisions (along with its detailed reasoning for doing so) and revising the other two provisions. The DOL also updated its FFCRA FAQs to reflect these clarifications.
Read MoreOn September 8, 2020, the Equal Employment Opportunity Commission (“EEOC”) posted an updated “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws” (“WYSK”). The updated WYSK modifies two existing Q&As and adds 18 new Q&As that have been adapted from two other EEOC technical assistance resources: “Pandemic Preparedness in the Workplace and the Americans with Disabilities Act” and a March 27, 2020 publicly available EEOC webinar.
Read MoreEmployers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to whether the drug coverage provided under the plan is “creditable” or “non- creditable.” This notification must be provided prior to October 15th each year. Also, following the plan’s annual renewal, the employer must notify the Centers for Medicare & Medicaid Services (“CMS”) of the creditable status of the drug plan.
Read MoreThe New York State Department of Financial Services has announced the contribution rate and benefit schedule under the New York Paid Family Leave (“PFL”) law effective January 1, 2021.
Read MoreThe Department of Labor’s Wage and Hour Division (“the Department”) added three new FAQs to clarify when benefits are available under the Families First Coronavirus Response Act (“FFCRA”) as the school year begins.
Read MoreOn August 17, 2020, a U.S. district court decided in the case of Walker v. Azar to block enforcement of final regulations from the U.S. Department of Health and Human Services (“HHS”) relating to section 1557 of the Affordable Care Act, to the extent that the regulations fail to define sex discrimination as including discrimination based on sexual orientation and gender identity. This means discrimination on the basis of sexual orientation and gender identity is prohibited by section 1557.
Read MoreAmerica's workers concerned about the financial impact of treatment for COVID-19 and other infectious diseases have a new option for protection.
Colonial Life today released a new group critical illness plan with an optional rider that offers a lump sum benefit for hospitalization for treatment of COVID-19 and more than a dozen other infectious diseases such as antibiotic-resistant bacteria, Legionnaires' disease, meningitis, Lyme disease and sepsis.
Read MoreCOVID-19 set the stage for the rapid adoption of Telehealth services. It’s estimated that these services will soar to more than 1 billion in 2020, including 900 million visits related to COVID-19, according to Forrester Research.
UnitedHealthcare acted quickly at the beginning of the pandemic and expanded access to Telehealth for health plan members, including waiving member cost-sharing, expanding networks and taking advantage of regulatory flexibility from the Centers for Medicare & Medicaid Services (CMS). The company experienced almost 3 times as many Telehealth visits in the first 4 months of 2020 versus all of 2019.
Read MoreOn August 3, 2020, the U.S. District Court for the Southern District of New York invalidated four separate provisions in temporary regulations previously issued by the U.S. Department of Labor (“DOL”) regarding emergency paid leave under the Families First Coronavirus Response Act (“FFCRA”).
It appears the Court’s decision may apply with respect to certain counties in New York. However, it is not clear whether the ruling applies nationally or retroactively. In addition, the DOL is likely to appeal the decision which may create additional uncertainty.
Read MoreOn August 3, 2020, the U.S. Department of Labor’s Wage and Hour Division published two FAQs for employers that have a service contract with the federal government covered by the Service Contract Act (“SCA”) or a federal construction contract covered by the Davis-Bacon and related Acts (“DBRA”). The FAQs help explain when fringe benefits must be provided to employees taking paid leave under the Families First Coronavirus Response Act (“FFCRA”).
Read MoreNew Jersey Governor Phil Murphy signed Assembly Bill 4389 into law on Friday, July 31. The New Jersey law, effective January 1, 2021, imposes a 2.5% tax on the net premiums collected for individual and large group health plans and is estimated to generate nearly $220 million annually. The funds will be used make insurance more affordable for working and middle-class consumers.
Read MoreThe IRS recently announced in Revenue Procedure 2020- 36 that the Affordable Care Act (“ACA”) affordability indexed amount under the Employer Shared Responsibility Payment (“ESRP”) requirements will be 9.83% for plan years that begin in 2021. This is an increase from the 2020 percentage amount (9.78%).
Read MoreThe Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) recently released a notice of proposed rule making regarding grandfathered group health plans and grandfathered group health insurance coverage.
Read MoreOn July 23, 2020, the Secretary of Health and Human Services (“HHS”), Alex Azar, declared the Public Health Emergency, scheduled to end on July 25, 2020, will once again be extended for an additional 90 days and as a result, numerous temporary benefit plan changes remain in effect.
Read MoreThe Supreme Court recently ruled in a 7-2 decision to uphold regulations that expand the Affordable Care Act (“ACA”) contraception exemptions.
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