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SIMA Financial Group > Benefits (Page 5)

2020 DOL Penalty Amounts for ERISA Violations Issued

The U.S. Department of Labor (DOL) has increased the penalties employers face under ERISA for group health plan reporting and disclosure failures. These new amounts apply to penalties assessed after Jan. 15, 2020, and include the following: Summary of Benefits and Coverage (SBC): Failure to provide group health plan participants and beneficiaries with an SBC may now result in a penalty of up to $1,176 per participant or beneficiary. Employer CHIP Notice: Failure to provide a CHIP Notice to employees in states that offer group health plan premium assistance through a state Children's Health Insurance Program may now result in...

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Cadillac Tax Repealed / PCOR Fee Renewed

The SECURE Act President Trump has signed a year-end spending package that will fund the federal government through September 30, 2020.  The Setting Every Community Up for Retirement Enhancement  (SECURE) Act of 2019 is included in that spending package.  The SECURE Act contains significant changes to retirement plan regulations.  It also contains some significant changes affecting employer health plans. Repeal of the Cadillac Tax The SECURE Act fully repeals the very controversial Affordable Care Act (ACA) excise tax on high-cost employer-sponsored plans, more widely known as the Cadillac Tax.  The Cadillac Tax would have imposed a 40% excise tax on the cost of...

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Medicare Part D Creditable Coverage Notice 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 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 also available. NOTE: If you are offering an actual Part D Plan, you are exempt from this filing requirement. Employers who have applied for a retiree drug subsidy are NOT required to complete this form. You will...

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New Summary of Benefits and Coverage Template Will Be Required for 2021

Recently, the Departments of Labor (DOL) and Health and Human Services (HHS) issued an updated template and related materials for the summary of benefits and coverage (SBC). These materials are required to be used for plan years beginning on or after Jan. 1, 2021. This means that the updated template must be used for the 2021 plan year’s open enrollment period. The SBC is a concise document providing simple and consistent information about health plan benefits and coverage. Employers should prepare to use the new SBC template and related materials for the 2021 plan year. Prior to the beginning of the 2021...

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Upcoming Group Health Plan Compliance Dates

Employers must comply with numerous reporting and disclosure requirements throughout the year in connection with their group health plans. Listed below are upcoming important compliance deadlines for employer-sponsored group health plans, organized chronologically. For these requirements, the information provided herein shows the deadlines that apply to calendar year plans. For non-calendar year plans, these deadlines will need to be adjusted to reflect each plan’s specific plan year. January 2020 Employers that filed 250 or more IRS Forms W-2 for the prior calendar year must file Forms W-2 with the Social Security Administration and furnish Forms W-2 to employees by Jan. 31 of...

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IRS Releases Final Forms and Instructions for 2019 ACA Reporting

The 2019 ACA Reporting is Due in Early 2020 The IRS has released final 2019 versions of Forms 1094-C, 1095-C, 1094-B, and 1095-B that employers will use in early 2020 to report on the group health insurance coverage they offered during the 2019 calendar year. Instructions on how to complete Forms 1094-C and 1095-C and Forms 1094-B and 1095-B for the 2019 calendar year have also been released. The 2019 forms and instructions are substantially similar to the 2018 versions. Note that Section 6055 reporting continues to be required, despite the fact that the individual mandate penalty has been reduced to $0....

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DOL Issues 2020 Form W-4

Employers Must Begin Using the New Form Jan. 1 On Dec. 5, 2019, the Internal Revenue Service released an updated version of its W-4 form, also known as the “Employee’s Withholding Certificate.” Employers use IRS Form W-4 to determine each employee’s federal tax withholdings. The new form is intended to harmonize tax withholding declarations with the Tax Cuts and Jobs Act, which affected individuals for the first time during the last tax filing season. Employees may complete a new W-4 each year or each time they experience a change in their personal financial situation. However, the new form does not invalidate prior...

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Have your employees visited the doctor this year?

Small life decisions can have a huge impact on your health. Those who don’t see a doctor once a year risk greater health complications down the road. Since most health plans cover an annual visit, there’s no reason to skip a checkup.  It's a great time to remind your employees to see their doctor before the year ends! [video width="1920" height="1080" mp4=""][/video]...

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How Employers Should Handle MLR 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 are issued to plan sponsors by September 30 of the following year and have three months to distribute the rebate to eligible plan enrollees. Employer Distribution The MLR rules provide that issuers must pay any rebates owed to persons covered under a group health plan to the policyholder, who is then responsible for distributing...

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