Compliance Corner
September 17, 2019


Podcast 60: Q4 Updates on the HIT, Cadillac Tax, and Lawsuit Challenging the ACA
September Get Wise Wednesdays: Register Now
Reminder: Calendar Year SAR Must Be Distributed by September 30, 2019
It’s MLR Rebate Time Again!
Reminder: Medicare Part D Notice to Employees Deadline Is October 14, 2019

Federal Health Updates

Agencies Issue Final MHPAEA FAQ, Disclosure Form, and 2018 Enforcement Report
DOL Opinion Letter: FMLA Designation Can't Be Delayed by Leave Provided Under Collective Bargaining Agreement
DOL Opinion Letter: Employer HSA Contributions Are Not Earnings for Wage Garnishment Purposes

Retirement Updates

New Mailing Address for IRS Submissions
Expanded Determination Letter Program for Hybrid and Merged Plans Effective

State and Territory Updates



If an employer adds coverage mid-plan-year to allow employees to cover domestic partners, would that be a qualifying event and allow employees to change their elections?


Podcast 60: Q4 Updates on the HIT, Cadillac Tax, and Lawsuit Challenging the ACA

In this episode, Chase Cannon and Suzanne Spradley look at a few ACA topics that are a bit up in the air. The first is the health insurance tax (HIT), a tax on health insurance carriers that has been on and off moratorium the past few years, but is coming back into effect for 2020. Chase breaks down the HIT, its impact on health insurance rates and on employers and employees, and whether Congress might add a moratorium for 2020 or repeal the HIT entirely. The second is the Cadillac Tax, a tax on plans that provide richer benefits. Chase and Suzanne discuss the potential issues and burdens associated with the Cadillac tax, why it was enacted, and whether the Senate might follow the House’s lead on repealing it. The third is Texas v. the U.S., the lawsuit challenging the constitutionality of the ACA’s individual mandate. Chase breaks down the lawsuit, the validity of the arguments on either side, and gives a prognosis on how and when the Fifth Circuit might rule on the case. The two close the podcast by looking to the case’s potential impact on the 2020 elections.

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.

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September Get Wise Wednesdays: Register Now

NFP's Benefits Compliance team is hosting its next webinar on September 18, 2019, from 2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET). The topic is "Top 10 Compliance Tips for Open Enrollment."

Can't make a live webinar? A recording of each session 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.

The moderator will answer as many questions as possible during the webinar. If your question isn't answered by the end of the webinar, reach out to your advisor for assistance.

Top 10 Compliance Tips for Open Enrollment
September 18, 2019

Register Now »

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

Reminder: Calendar Year SAR Must Be Distributed by September 30, 2019

Plans that are subject to ERISA and Form 5500 filing must distribute the SAR to participants within nine months of the end of the plan year; thus, a calendar year plan is required to distribute the SAR for the 2018 plan year by September 30, 2019. If the plan applied for an extension to the Form 5500 filing, the SAR is then due within two months following that filing.

The SAR is a summary of the plan’s information reported on the Form 5500. If a plan is not subject to Form 5500 filing, then it is exempt from the SAR notice requirement — this would include church plans, governmental plans, and unfunded or insured plans with fewer than 100 participants. Also, large, unfunded self-insured plans are exempt from the SAR requirement even though they are subject to the Form 5500 filing requirement.

Model language is available for SAR preparation. Please ask your advisor for assistance. For additional information, see the frequently asked question featured in the August 23, 2016, edition of Compliance Corner.

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, 2019, and September 30, 2019. 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."

Reminder: Medicare Part D Notice to Employees Deadline Is October 14, 2019

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, 2019. This notice serves to put Medicare-eligible individuals on notice 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.