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…
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…
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…
Policies Renewed Under Extended Transitional Policy Must End by December 31, 2019 A previously extended transitional policy which allows health insurance issuers, at their option, to continue group coverage that would otherwise be terminated or cancelled has been further extended to policy years beginning on or before October 1, 2019, provided that all policies end…
