Compliance Corner
October 13, 2020

COVID-19 Updates

COVID-19-Related Benefits Compliance Resources Available

Announcements

Podcast Episode 90: Deadline Extensions, Proclamations on National Emergencies, and a State Compliance Blitz
October Get Wise Wednesdays Webinar – Register Now
It’s MLR Rebate Time Again!
Final Reminder: Medicare Part D Notice to Employees Deadline Is October 14, 2020

Healthcare Reform

Once Again, IRS Extends ACA Reporting Deadlines and Offers Penalty Relief
IRS Releases Publication 5164, Test Package for 2020 Electronic ACA Filers

Federal Health Updates

Tenth Circuit: Employer’s Discretionary Authority Must be Communicated to Plan Participants

Retirement Updates

IRS Publishes 2020 Form 4972, Tax on Lump-Sum Distributions

State and Territory Updates

California
Colorado
Florida
Michigan
New Jersey
New York
Oklahoma
Pennsylvania

FAQs

FAQ: Our insurance carrier has agreed to extend our coverage period for an additional two months. What are the compliance implications of a 14-month plan year?


ANNOUNCEMENTS

Podcast Episode 90: Deadline Extensions, Proclamations on National Emergencies, and a State Compliance Blitz

In this episode, Chase Cannon and Suzanne Spradley address some confusion on recent HHS announcements extending their emergency declarations. Chase begins by describing two pandemic-related requirements — one relating to FFCRA/CARES Act COVID-19 testing/diagnosis, and one relating to the deadline extensions for COBRA notices and premium payments, HIPAA special enrollment windows, and claims appeals. Chase and Suzanne describe the differences in the HHS and White house declarations of national emergencies, which drive the effective time periods for the requirements themselves. Suzanne finishes with lightning-round questioning of state developments, as Chase describes recent developments in California, Colorado, Pennsylvania, New York and Washington.

Every other week, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page every two weeks for the most up-to-date episode.

Subscribe to The Benefits Compliance Podcast!Listen on Google Play Music


October Get Wise Wednesdays Webinar – Register Now

Join us as we outline COBRA’s requirements, provide tips on how to remain compliant and discuss some of the ways that the COVID crisis has impacted plans’ COBRA administration.

Contending with COBRA: General Tips and COVID-19 Implications
October 21, 2020
2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET)
Register Now »

A recording will be posted to the NFP Client Learning Portal within 48 hours of the live webinar. Those listening to a recorded webinar aren’t eligible for recertification credit.

All programs are pending approval for 1.0 (general) recertification credit hour toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at www.hrci.org.


It’s MLR Rebate Time Again!

The ACA requires insurers to submit an annual report to HHS accounting for plan costs. If the insurer does not meet the medical loss ratio standards, they must provide rebates to policyholders. Rebates must be distributed to employer plan sponsors between August 1, 2020, and September 30, 2020. Employers should keep in mind that if they receive a rebate, there are strict guidelines as to how the rebate may be used or distributed.

For more information, please contact your advisor for a copy of “Medical Loss Ratio Rebates: A Guide for Employers” or “Medical Loss Ratio: PPACA’s Rules on Rebates.”


Final Reminder: Medicare Part D Notice to Employees Deadline Is October 14, 2020

Employers must notify individuals who are eligible to participate in their medical plan whether the plan’s prescription drug coverage is “creditable” or “non-creditable” as compared to Medicare Part D coverage.

As a reminder, the Medicare Part D notice of creditable coverage should be distributed to employees by October 14, 2020. This notice serves to inform Medicare-eligible individuals of whether or not their employer group coverage is creditable. That information is necessary to help such individuals avoid paying higher premiums (also known as late enrollment penalties) for Medicare Part D coverage.

Employers should consult with their service providers to determine whether their coverage is creditable using either the simplified determination method or an actuarial analysis. Also keep in mind that CMS provides a model notice for employers.