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Benefits

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Employees Terminated for Gross Misconduct Not Eligible for Mini Cobra

Law Effective July 1, 2018 Virginia has amended its mini-COBRA law to exclude covered employees terminated for gross misconduct. Additional details are presented below. Amended Law Effective July 1, 2018, mini-COBRA is not available to an individual whose eligibility for coverage under the group policy ceased because the individual was discharged for gross misconduct. Gross misconduct means any conduct connected with the individual's work that would constitute misconduct under Virginia unemployment law, including deliberately and willfully engaging in conduct that demonstrates a complete disregard for the employer's workplace standards and policies. Click here for more. Background Virginia generally requires employers to provide the right...

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Reminder: PCORI Fees Due Soon

Affected Employers Must File IRS Form 720 Employers that sponsor certain self-insured health plans—including some health reimbursement arrangements (HRAs) and health flexible spending arrangements (health FSAs)—are reminded that they are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Fees for self-insured plans with plan years that ended in 2017 are due July 31, 2018, and are required to be paid via IRS Form 720, Quarterly Federal Excise Tax Return. Employer-sponsored self-insured plans with plan years that ended between January 1, 2017 and September 30, 2017 must pay a fee of $2.26 multiplied by the average number of lives covered under the plan....

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How Summer Hires May Impact ALE Status

Employers May Apply a Reasonable, Good Faith Interpretation of the Term 'Seasonal Worker' Employers looking to hire seasonal workers this summer are reminded that there is an exception when measuring workforce size to determine whether they are an applicable large employer (ALE) subject to the Affordable Care Act's employer shared responsibility ("pay or play") provisions. What Is 'Pay or Play'? The pay or play provisions require ALEs—generally those with at least 50 full-time employees, including full-time equivalent employees (FTEs)—to offer affordable health insurance that provides a minimum level of coverage to full-time employees (and their dependents) or pay a penalty tax if any...

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Employers: Don’t Forget to Pay PCORI Fees

Affected Employers Must File IRS Form 720 Employers that sponsor certain self-insured health plans—including some health reimbursement arrangements (HRAs) and health flexible spending arrangements (health FSAs)—are reminded that they are responsible for Patient-Centered Outcomes Research Institute (PCORI) fees. Fees for self-insured plans with plan years that ended in 2017 are due July 31, 2018, and are required to be paid via IRS Form 720, Quarterly Federal Excise Tax Return. Employer-sponsored self-insured plans with plan years that ended between January 1, 2017 and September 30, 2017 must pay a fee of $2.26 multiplied by the average number of lives covered under the plan....

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IRS Releases 2019 ACA Affordability Threshold

The IRS has released a Revenue Procedure, which increases the affordability threshold for ACA (“Affordable Care Act”) Employer Mandate Purposes (“Pay or Play”) to 9.86% for plan years beginning in 2019. For reference purposes: 2015 Percentage: 9.56%  2016 Percentage: 9.66% 2017 Percentage: 9.69% 2018 Percentage: 9.56% 2019 Percentage: 9.86% The Pay or Play rules only apply to employers considered Applicable Large Employers” or “ALEs”.  In general, ALEs are employers that employee an average of at least 50 full time plus full time equivalent employees on business days in during the preceding year.  Under the ACA’s Pay or Play rules, ALEs must offer affordable and adequate coverage to...

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Creditable Coverage Disclosure Reminder

All group health plans that provide prescription drug coverage to Medicare Part D eligible individuals (whether actively working, retired, or disabled) are required to notify CMS whether or not the coverage provided is creditable. This disclosure must be filed with the Department of Health and Human Services within 60 days of the start of the plan year, and it is required whether the coverage is primary or secondary to Medicare. Employers must file their Disclosure Notice through the CMS website Instructions and guidance on completing the Notice are available here. NOTE: If you are offering an actual Part D Plan, you are exempt...

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IRS Announces HSA Limits for 2019

On May 10, 2018, the IRS released Revenue Procedure 2018-30 to announce the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2019. These limits include: The maximum HSA contribution limit; The minimum deductible amount for HDHPs; and The maximum out-of-pocket expense limit for HDHPs. These limits vary based on whether an individual has self-only or family coverage under an HDHP. The IRS limits for HSA contributions will increase for 2019. The HDHP maximum out-of-pocket limits will also increase for 2019. The HSA contribution limits will increase effective Jan. 1, 2019, while the HDHP limits will increase effective for plan...

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Non Discrimination & Classing Rules for Health Plans: An Employer’s Guide

Group health plans and tax-favored accounts—including health savings accounts (HSAs), health flexible spending arrangements (health FSAs), and health reimbursement arrangements (HRAs)— are subject to numerous nondiscrimination provisions under federal law. As a result, employers that wish to adopt arrangements which exclude certain classes of employees from group health plan coverage or offer different benefits or contributions to different classes of employees (e.g., managerial vs. non-managerial) must analyze these arrangements under several laws to determine whether such treatment is permissible. The following provides a summary of key nondiscrimination requirements that may apply to group health plans and tax-favored accounts under federal...

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Final Regulations – 2019 Notice of Benefit and Payment Parameters

On April 9, 2018, the Department of Health and Human Services (HHS) issued final regulations and related guidance on Affordable Care Act (ACA) provisions including Essential Health Benefits (EHBs), out-of-pocket (OOP) maximums, and Marketplace updates and reforms. These regulations, generally effective for plans and plan years beginning on and after Jan. 1, 2019, largely mirror the proposed regulations issued Oct. 27, 2017. The final rule affords greater flexibility to states for determining EHBs, reduces some regulatory requirements in the individual and small group markets and provides annual benefit provision updates. Additional guidance expands the individual mandate hardship exemptions available for 2018...

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$6,900 Re-Established as 2018 HSA Contribution Limit for Certain Individuals

The Internal Revenue Service (IRS) has re-established $6,900 as the 2018 health savings account (HSA) contribution limit for individuals with family coverage under a high deductible health plan (HDHP). This limit was previously announced as $6,900 in May 2017, but was revised to $6,850 in March 2018 due to an inflation adjustment provision in the Tax Cuts and Jobs Act. The 2018 health savings account (HSA) contribution limit for individuals with self-only coverage under a HDHP remains unchanged at $3,450. Click here to read the IRS announcement.   ...

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