Health and Welfare Team

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.

On December 14, 2018, a US District Judge in Texas issued a ruling that the entire ACA was unconstitutional given that the individual mandate contained in it no longer had a tax penalty, the basis of the 2012 US Supreme Court ruling upholding the ACA's constitutionality. 

Gary Kushner, a frequent contributor to national and regional media, was quoted in the Washington Post responding to a question about open enrollment timelines.

The IRS has announced the limits for employee benefit plans for 2019.

The employer mandate penalty notices for 2016 have been mailed the week of November 12, 2018. Better known as Letter 226-J, these notices inform employers of a preliminary penalty under IRC Section 4980H.

When Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act in 2003 implementing prescription drug coverage under Medicare, it required all employers that offer prescription drug benefits to provide an annual notice to all Medicare-eligible plan participants.

Starting in 2007, the Tax Relief and Health Care Act of 2006 (TRHCA) requires that the IRS release the upcoming year’s new HSA limits prior to June 1st.