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…

Open Enrollment: What’s Changing in 2020?

To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2020. Employers should review their plan documents to confirm that they include these required changes. In addition, any changes to a health…

Reminder: Medicare Part D Notices Are Due Before Oct. 15

Requirement Applies to Employers that Offer Prescription Drug Coverage Employers who sponsor group health plans that offer prescription drug coverage to Medicare-eligible individuals must provide a Medicare Part D Creditable or Non-Creditable Coverage Notice to those individuals before October 15. These notices inform Medicare-eligible individuals whether the plan’s prescription drug coverage is expected to pay,…

IRS Confirms ACA Pay or Play Penalties Still Apply – See Q&A including payment info

No Waiver or Transition Relief is Currently Available Recently, the Internal Revenue Service released an information letter regarding the Affordable Care Act’s employer shared responsibility (pay or play) penalties. The information letter is intended to clarify the applicability of the penalties in light of President Trump’s 2017 executive order broadly directing federal agencies to waive,…