The IRS has issued Notice 2016-70, which provides a 30-day extension to the deadline for Applicable Large Employers ("ALEs") to distribute the 2016 Affordable Care Act ("ACA") reporting forms to employees and covered individuals. NOTE: This extended deadline applies only to distributing the 2016 ACA reporting forms to employees and covered individuals and not to [...]
While most group health plans contain an exclusion for medical and investigational procedures, the scope and the pace at which medical procedures and treatments are tested in the 21st century makes this an extremely difficult standard to apply. There is no bright-line test, experts frequently disagree as to when the line has been crossed, and [...]
"Anthem and Cigna have quarreled for months behind the scenes even as their push to combine has moved forward, with each company accusing the other of violating their $48 billion agreement... The newly unsealed testimony showed that, among other things, Cigna officials have questioned Anthem's plans for their company postmerger, while Anthem executives have tried [...]
A U.S. District Court has determined, in Perez v. Scott Brain, that an employee benefit trust fund's trustee and legal counsel engaged in illegal activity when they retaliated against a fund employee who communicated with the Department of Labor during its investigation of the fund's administration. (Solutions Law Press)
"Almost from its inception, the [Hospital Insurance (HI)] Trust Fund has faced a projected shortfall. The insolvency date has been postponed a number of times, primarily due to legislative changes that have had the effect of restraining growth in program spending. The 2016 Medicare trustees' report projects that, under intermediate assumptions, the HI Trust Fund [...]
"Your HSA trust agreement cannot limit your reimbursements to eligible expenses... Your trustee must provide at least one way for you to make distributions (withdrawals) for non-eligible expenses.... Your trustee can place certain restrictions on distributions.... Your HSA trustee does not track your deposits to ensure that you don't exceed your maximum annual contribution.... Your [...]
"For business associates, desk audits will target breach notification and the security rule's risk analysis and risk management requirements. The U.S. Department of Health and Human Services' Office for Civil Rights (OCR) intends for the desk audits to begin any time now and to conclude by the end of the year. Next year, OCR plans [...]
A U.S. District Court has determined, in EEOC v. Orion Energy Systems, Inc., that an employer's wellness program, which requires employees who had enrolled in its group health plan to undergo health risk assessments or pay full premium costs, was voluntary and did not violate the Americans with Disabilities Act ("ADA"). Nevertheless, the court indicated [...]
"Employers that offer flex contributions and/or opt-out payments face some unique issues in determining if the health coverage they offer to employees is affordable under the ACA's shared responsibility rules. Depending on how the program is structured, these contributions and payments can adversely affect affordability." (Xerox HR Services)
"QUESTION: Our company offers a calendar-year cafeteria plan with a health FSA funded through employee salary reductions. The health FSA is subject to COBRA, and our plan documents provide that health FSA coverage ends upon termination of employment. Before year-end, we expect to eliminate several positions at our company. Can we amend our plan to [...]