We posted on April 6th about the COBRA subsidy that was made available through the American Rescue Plan Act of 2021 (ARPA). In short, the law gives certain individuals who are entitled to COBRA due to a reduction of hours or involuntary termination of employment a 100% subsidy for health coverage that is continued under COBRA or equivalent state laws. Read more
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We previously blogged about the new Mental Health Parity and Addiction Equity Act (MHPAEA) reporting and disclosure requirements established by the Consolidated Appropriation Act, 2021 (CAA). As a refresher, employers and carriers that sponsor group health plans are now required to provide upon request a full analysis of the process followed by the plan in establishing non-quantitative treatment limitations (NQTLs) for the plan and the impact these NQTL’s have on mental health and substance use disorder (MH/SUD) benefits provided by the plan. This disclosure requirement went into effect on February 10, 2021. Read more
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The COBRA subsidy from the most recent COVID-19 stimulus bill – The American Rescue Plan Act of 2021 (ARPA) – is now in effect. An assistance-eligible individual can have 100% of COBRA premiums subsidized for the periods beginning April 1, 2021 through September 30, 2021. All plan sponsors must offer the subsidy – it is not optional.
Eligible former employees and spouses/dependents (qualified beneficiaries) can receive the subsidy if they are already on COBRA. In addition, individuals who declined or dropped COBRA coverage can elect into COBRA under a “second bite at the apple” election process, if they are still in the remaining period of COBRA coverage that would have applied originally. Read more
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The myriad health and welfare plan requirements in the Consolidated Appropriations Act, 2021 include those for a group or individual health plan to maintain a cost comparison tool and an accurate and up-to-date network provider/facility directory for participant use. Each of these requirements is effective for plan years beginning on and after January 1, 2022. While the group health plan is responsible for compliance, in most cases the plan’s TPA will in practice be supplying this information to participants. Read more
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In sum, under last year’s DOL guidance, employers were required to disregard the period from March 1, 2020 until 60 days after the president declared the COVID Pandemic National Emergency over (the “Outbreak Period”) in calculating employee notices and election deadlines for deadlines including the following:
The 30-day period (or 60-day period, if applicable) to request special enrollment under ERISA
The 60-day election period for COBRA continuation coverage
The date for making COBRA premium payments
The date for individuals to notify the plan of a qualifying event or determination of disability under COBRA
The date within which individuals may file a benefit claim under the plan’s claims procedures
The date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure
The date within which claimants may file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination
The date within which a claimant may file information to perfect a request for external review upon a finding that the request was not complete
With respect to group health plans, and their sponsors and administrators, the date for providing a COBRA election notice
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Employee benefit plans are subject to numerous laws that restrict, or at least limit, discrimination within the plans. Many benefit plan nondiscrimination rules focus on whether highly and non-highly compensated employees are receiving equal treatment under those plans; however, the recently enacted Consolidated Appropriations Act, 2021 (CAA) is bringing some attention to an often-overlooked discrimination rule that prohibits group health plans from discriminating with respect to mental health and substance use disorder benefits (MH/SUD benefits). Read more
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Should auld acquaintance be forgot…not if they relate to the Affordable Care Act reporting requirements. In the midst of the flurry of health and welfare changes coming from the Consolidated Appropriations Act, employers can’t forget about the “auld” Affordable Care Act. Since the 2015 tax year, large employers of self-insured health plans have been required to report to employees and the IRS information regarding the health insurance offered. Form 1095-C is used to report this information to employees. There have been a few changes to the Form 1095-C for the 2020 tax year that employers should keep in mind: Read more
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On December 27, 2020 Congress passed the Consolidated Appropriations Act, 2021 (CAA). The CAA provides relief for employees whose dependent care and health care FSA accounts were impacted by the pandemic. This relief will allow employers to amend their FSAs to essentially eliminate the so called “use it or lose rule” for FSA balances not used by the end of 2020 and 2021. This relief is accomplished by giving participants up to an additional year to use the unspent amounts in their FSA accounts. Please see a more detailed description of this relief here.
In addition, the CAA also permits employers to amend their dependent care and health care FSAs to permit contribution election changes (e.g., to start, stop, increase or decrease FSA elections) throughout 2021 for any reason. Please see a more detailed description of this relief here. Read more
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On January 7, 2021, the Equal Employment Opportunity Commission unveiled two Notices of Proposed Rulemaking regarding what employers can do to encourage workers to participate in corporate wellness programs without violating the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act. The proposed rules mandate that employers “offer no more than de minimis incentives” to entice workers to take part in most wellness programs, but that employers can raise or lower workers’ insurance contributions by up to 30% (or 50% to the extent the wellness program is designed to prevent or reduce tobacco use), to encourage employees to take part in “a subset of wellness programs that are part of employer health plans.” Read more
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One of the employee benefits items tucked into the recently-passed Consolidated Appropriations Act, 2021 (the “Act”) will soon require group health plan service providers to issue fee disclosures.
Service providers to retirement plans have been required to provide fee disclosures – the ERISA 408(b)(2) disclosures – to plan sponsors for the past 10 years. The disclosures are part of the “reasonable compensation” exemption that keeps the arrangement from being a prohibited transaction. Until now, the 408(b)(2) fee disclosure rules have not applied to health and welfare plans; the “No Surprises Act” portion of the Act changes that next year. Read more
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