ERISA-ACA Compliance

Employers that offer prescription drug benefits are required to provide an annual notice to all Medicare-eligible plan participants and qualified beneficiaries before October 15th of each year, the start of the Medicare open enrollment period. Most send it to all participants.

In two new IRS Notices (2020-29 and 2020-33), there are temporary changes to the rules governing Flexible Spending Accounts (FSAs) through 2020 due to COVID-19, and permanent changes to both FSAs and certain Health Reimbursement Arrangements (HRAs) that will begin this year. 

In an IRS News Release (IR 2020-57) issued on March 20, 2020, the IRS announced that they will shortly provide guidance that employers with fewer than 500 employees may retain payroll taxes withheld from employees’ paychecks for the tax credits for emergency paid leave.

On February 26, 2020, the US Supreme Court ruled in Intel Corporation Investment Policy Committee v Sulyma that under ERISA a plan participant "must have 'actual knowledge' of the information contained in required disclosures he receives but does not read or cannot recall reading."

Much later than usual, the IRS released the 2020 retirement plan contribution limits. Earlier this year, they also released the High Deductible Health Plan (HDHP) and Health Savings Account (HSA) limits. We now also have the cafeteria plan, adoption credit, and transit benefit limits as well.

The US Department of Labor has suddenly realized that employers and their employees use a newfangled means of communicating in the real world: e-mail and the internet. In a bold move proposing their latest regulations he DOL has proposed new rules.

Since 2009, special enrollment rights to immediately enroll in an employer's health plan arise if an individual becomes eligible for a state premium assistance subsidy under Medicaid or the Children's Health Insurance Program Reauthorization Act ("CHIPRA", or often shortened to CHIP).

Under the ACA, the Patient-Centered Outcomes Research Institute (PCORI) was established. The funding mechanism for PCORI was a fee on group health plans, including certain employer-contributed health care flexible spending accounts (employer FSAs) and Health Reimbursement Arrangements (HRAs).

Kushner President and CEO Gary Kushner was invited to present a 5-minute (and exactly 5 minutes) speech at this year's DisruptHR conference. His topic was on "Total Rewards: Why are We Doing What We're Doing?" Here's the video of that talk.

The U.S. Department of Labor (DOL) recently published an Information Letter that confirms the general preemption under ERISA of state civil laws that require employers to obtain written consent before withholding amounts from employees’ wages for contribution to a benefit plan subject to ERISA.

Employers who sponsor group health plans that cover any prescription drugs generally must disclose whether the plan provides creditable or non-creditable prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS) within 60 days of the start of a new plan year.

In a recent article published by SHRM, our President and CEO Gary Kushner was cited as the main resource on dealing with active employees and their dependents upon their reaching Medicare-eligibility. Kushner mentioned many issues related to employer-based health and prescription drug benefits.