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Benefits

Employee Benefits Plan Limits for 2021

Many employee benefits are subject to annual dollar limits that are periodically updated for inflation by the IRS. The IRS typically announces the dollar limits that will apply for the next calendar year well in advance of the beginning of that year. This gives employers time to update their plan designs and make sure their plan administration will be consistent with the new limits. Although some of the limits will increase for 2021, most of the limits remain the same. Increased Limits For plan years beginning on or after Jan. 1, 2021, the following limits have increased: Health savings account contributions: Single coverage—$3,600 (up...

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Final Rule on Health Care Transparency Issued

The Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a final rule that imposes new transparency requirements on group health plans and health insurers in the individual and group markets. Specifically, the final rule requires plans and issuers to disclose: Price and cost-sharing information to participants, beneficiaries and enrollees upon request: A list of 500 shoppable services must be available via the internet for plan years beginning or after Jan. 1, 2023. The remainder of all items and services is required to be available for plan years beginning on or after Jan. 1, 2024. In-network...

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PCORI Fee Amount Adjusted for 2021

The Fee is $2.66 per Covered Life for Plan Years Ending in 2021 The IRS issued Notice 2020-84, which increases the Patient-Centered Outcomes Research Institute (PCORI) fee amount for plan years ending on or after Oct. 1, 2020, and before Oct. 1, 2021. Specifically, the PCORI fee amount for plan years ending on or after Oct. 1, 2020, and before Oct. 1, 2021, is increased to $2.66 multiplied by the average number of lives covered under the plan. The IRS provided transition relief related to the 2020 PCORI fee calculation, due to the anticipated termination of the PCORI fee prior to its extension. This transition relief...

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Final Forms and Instructions for 2020 ACA Reporting Released

2020 ACA Reporting is Due in Early 2021 The IRS has released final 2020 forms and instructions for use in early 2021 to report under IRS Code Sections 6055 and 6056 for the 2020 calendar year. 2020 Form 1094-B and Form 1095-B (and related instructions) will be used by providers of minimum essential coverage (MEC), including self-insured plan sponsors that are not ALEs, to report under Section 6055. 2020 Form 1094-C and Form 1095-C (and related instructions) will be used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans. The forms and instructions include a...

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ACA Pay or Play Penalties Increase in 2021

The Adjusted Penalty Amounts for 2021 are $2,700 and $4,060 Under the Affordable Care Act’s employer shared responsibility (pay or play) rules, applicable large employers—generally those who have 50 or more full-time employees (including full-time equivalent employees)—may be subject to a penalty if they do not offer affordable coverage that provides minimum value to their full-time employees and their dependent children. Two separate penalties can apply under the employer shared responsibility rules—the Section 4980H(a) penalty and the Section 4980H(b) penalty. The Section 4980H(a) penalty can apply when an ALE does not offer coverage to “substantially all” full-time employees (and dependents). The annual...

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President Trump Issues Health Care Plan Executive Order

The America First Health Care Plan aims to Protect People with Preexisting Conditions and Combat Surprise Medical Billing On Sept. 24, 2020, President Donald Trump introduced his plan for affordable, high-quality health care, called the America First Health Care Plan. This plan, issued in an executive order, is primarily aimed at protecting people with preexisting conditions and combating surprise medical billing. The executive order directs the Departments of Health and Human Services (HHS), Labor and the Treasury to maintain and build upon existing actions to: Expand options for affordable health care and access to affordable medicines; Ensure consumers have access to meaningful price and...

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2020 Furnishing Deadline Delayed and Additional Transition Relief Granted

The IRS has delayed the deadlines by which employers must furnish 2020 Forms 1095-C and 1095-B in early 2021. For 2020, the furnishing deadline was Feb. 1, 2021, Since Jan. 31, 2021, is a Sunday. The IRS has provided an additional 30 days for furnishing the 2020 Form 1095-B and Form 1095-C, extending the due date from Feb. 1, 2021, to March 2, 2021. The deadline for filing with the IRS under Sections 6055 and 6056 remains March 1, 2021 (since Feb. 28, 2021, is a Sunday), or March 31, 2021, if filing electronically. The IRS provided additional relief from penalties related to failures...

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OPEN ENROLLMENT 2020: SIMA’s plans for a safe & seamless open enrollment period for our clients

2020 has certainly presented more than its share of challenges. Here at SIMA, with gratitude to our dedicated employees and exceptional technology team, we haven’t missed a beat. But, things do look a little different and will continue to do so for some time. And that includes during your company’s open enrollment period. Here's how SIMA will manage Open Enrollment 2020: Enrollment meetings, presentations and employee education will take place online. We are confident that SIMA’s electronic open enrollment system will make this change to a virtual format a seamless one. SIMA is equipped with an electronic benefits administration system that provides online access...

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