Over the last couple of years, the Department of Health and Human Services (HHS) conducted “desk audits” of 166 covered entities and 41 business associates. These audits focused on select HIPAA privacy, security and breach notification requirements. HHS has not released its official findings from the audits yet, but it has identified serious compliance gaps in…
The IRS released draft 2018 forms for Affordable Care Act (ACA) reporting under Internal Revenue Code (Code) Sections 6055 and 6056. Draft instructions for 2018 have not yet been released. The 2018 draft forms are substantially similar to the final 2017 versions. However, the revised version of the Form 1095-C clarifies that the “Plan Start…
Rule Permits Associations Based on Industry or Geography The U.S. Department of Labor (DOL) has issued a new rule that allows employers to join together as a single group to offer group health insurance coverage to employees, working owners (including those without other employees), and their spouses and dependents as part of an “association health…
The Affordable Care Act’s medical loss ratio (MLR) rules require group health insurance issuers to provide rebates if their MLR—the amount of health insurance premiums spent on health care and activities to improve health care quality—falls short of the applicable standard during a reporting year. Each year’s rebates must be issued to plan sponsors by…
Health plans with 100 or more plan participants at the beginning of a plan year are generally required to furnish a Summary Annual Report (SAR) to each health plan participant within 9 months after the end of a plan year. As a result, the deadline for most calendar year plans to satisfy the SAR requirement…
Overview of Employer Responsibilities for Handling Rebates The Affordable Care Act’s medical loss ratio (MLR) rules require group health insurance issuers to provide rebates if their MLR—the amount of health insurance premiums spent on health care and activities to improve health care quality—falls short of the applicable standard during a reporting year. Each year’s rebates…
New Rule Loosens Current Restrictions Effective October 3, 2018, a new rule will allow individuals to purchase short-term, limited-duration health insurance coverage for a period of less than 12 months, and renew such coverage for up to 36 months. Under current law, the maximum coverage period for short-term, limited-duration health insurance is less than 3…
Suicide is a leading cause of death for Americans, but much like mental health in general, the topic rarely gets the attention it deserves. There is a stigma against discussing suicide and mental health in the United States that hinders meaningful conversation about the topic. Open dialogue is an important part of preventing these tragic…
HIGHLIGHTS The final rule makes it easier for small employers to join together to purchase health insurance. According to the DOL, the changes expand access to affordable, high-quality health insurance coverage. Critics are concerned about potential risks to consumers and market stability. IMPORTANT DATES September 1, 2018 : Final rule applies to fully insured AHPs.…
Model Notices Previously Expired on June 30, 2018 The U.S. Department of Labor’s Wage and Hour Division (WHD) has extended the effective date of the following model FMLA notices through July 31, 2018: Notice of Eligibility and Rights & Responsibilities FMLA Designation Notice Certification of Employee’s Serious Health Condition Certification of Family Member’s Serious Health…
