Compliance FYIs

Apr 9, 2013
Exploring the Difference Between Common PPACA Terms
Do you know the difference between "essential health benefits" and "minimum essential coverage"? How about "minimum value coverage"? Read on and find out!
Apr 8, 2013
UBA Launches PPACA Resource Center
United Benefit Advisors (UBA) announces the launch of its compliance solutions aimed at helping employers understand their obligations and opportunities under the Patient Protection and Affordable Care Act (PPACA).
Mar 25, 2013
Agencies Propose Strict 90-Day Waiting Period
Federal agencies continue to issue details on the Patient Protection and Affordable Care Act (PPACA). The latest cover eligibility waiting periods, employee notices and claims appeals regulations.
Mar 15, 2013
Trusted Tools Can Help You Navigate PPACA
Need help wading through all those provisions and decisions related to the health care reform law? We have the top four resources that can put you on the right track and help you stay compliant.
Mar 5, 2013
DOL Issues New FMLA Forms and Notice
The U.S. Department of Labor has released revised model Family and Medical Leave Act (FMLA) forms to administer federal FMLA leave and a notice poster.
Feb 6, 2013
Significant Changes for Health Care Providers, Health Plans, and Their Business Associates and Subcontractors in Final HIPAA Privacy Regulations
The U.S. Department of Health and Human Services published its long-awaited final privacy and security regulations under HIPAA.
Jan 28, 2013
HHS Issues Proposed Rule on Exchange Liability
The IRS has released proposed rule provides some information on how employers will be notified if an employee applies for a premium subsidy / tax credit and how an employer may appeal a determination of premium subsidy eligibility that it believes is incorrect.
Jan 7, 2013
IRS Proposes Regulations for Employer Penalty Under PPACA
The IRS has released proposed regulations on the health care reform employer "shared responsibility" penalty provision.
Jan 2, 2013
Correcting Mistakes Can Eliminate Fiduciary Liability
Over the past decade, plan sponsors have become familiar with the voluntary correction programs offered by the IRS and Department of Labor, including the Service's Employee Plans Compliance Resolution System (EPCRS) and the DOL's Voluntary Fiduciary Correction Program (VFCP). These programs offer formal ways for sponsors to correct certain administrative errors in the operation of their plans.
Dec 28, 2012
DOL Begins Auditing Group Health Plans for PPACA, GINA, Wellness
The EBSA has updated its audit protocols to include a review of plans' compliance with the Patient Protection and Affordable Care Act (PPACA), the Genetic Information Nondiscrimination Act (GINA), and wellness programs, in addition to the laundry list of other federal benefits laws pertaining to group health plans.
Dec 27, 2012
Losing By Winning: Preventable Expenses
The circumstances behind a recent court decision were typical, and their consequences painfully predictable. Although the plan administrator "won," that victory does not reflect the huge -- and entirely unnecessary -- cost to the plan sponsor in terms of overhead and legal fees.
Dec 17, 2012
Failure to Timely Allocate Forfeitures Can Be Costly
Sponsors of 401(k) plans often fail to timely use or allocate forfeitures, thereby potentially disqualifying the plan. Recent IRS audits have revealed a renewed focus on the proper use of forfeitures -- making compliance a top priority for plan sponsors.
Dec 10, 2012
Court Holds TPA as ERISA Fiduciary
In a somewhat surprising opinion, a Michigan federal trial court recently held that a third-party administrator (TPA) of two self-funded employer health plans was an ERISA fiduciary. As a result, the TPA was held liable for breaching its fiduciary duty by not disclosing certain fees that had been charged to the plans.
Dec 3, 2012
Same-Sex Couples Still Not 'Married' For Federal Tax Purposes
The Internal Revenue Service (IRS) has recently issued guidance, through answers to frequently asked questions (FAQs), clarifying how same-sex couples who are in state-recognized domestic partnerships, civil unions, or marriages should file their federal income tax returns.
Nov 30, 2012
HHS Issues Proposed Rule on Essential Health Benefits and Actuarial Value
The federal government has issued a proposed rule that addresses some of the questions surrounding essential health benefits and determining actuarial and minimum value.
Nov 29, 2012
Highlights of New Proposed PPACA Wellness Rules
The federal government has issued a proposed rule that addresses how wellness programs may operate under the health care reform law beginning in 2014.
Nov 8, 2012
What Does the Election Mean for Employers?
The "status quo" in Washington D.C. means that health care reform will proceed, and employers must be ready to comply.
Oct 29, 2012
2013 Annual Benefit Plan Amounts
Following recent announcements by both the IRS and the Social Security Administration, we now know most of the dollar amounts that employers will need to administer their benefit plans for 2013.
Oct 23, 2012
A Costly Mistake: Failing to Timely Offer COBRA Coverage
Sponsors of self-funded health plans often fail to offer COBRA coverage on a timely basis to employees who are placed on a leave of absence. This mistake can lead to a most unpleasant result – the denial of stop loss coverage.
Oct 19, 2012
Critical Amendment Deadline Approaching for Defined Benefit Plans
Sponsors of single-employer defined benefit pension plans will need to amend those plans soon to comply with a critical requirement of the Pension Protection Act of 2006.
Oct 15, 2012
Unintended Consequences of Individual Benefit Discussions
It happens all the time: Employees who are considering retirement ask HR staff about their post-employment benefits. If the answers those employees receive turn out to be incorrect, the responders may be accused of violating their fiduciary duties under ERISA, and the plans at issue may be required to pay unexpected benefits.
Oct 15, 2012
Employers Remain Uncertain on Impacts of PPACA
Employers will have a number of obligations and opportunities as the heart of the Patient Protection and Affordable Care Act of 2010 (PPACA) is implemented in 2014. But if they are only listening to the chatter of the debates, they are not getting the whole story.
Oct 8, 2012
ERISA Section 408(B)(2) Disclosures: Now What?
By now, most retirement plan sponsors will have received a flurry of disclosures from vendors who provide services to their plans. Those disclosures (commonly known as 408(b)(2) notices) should have been provided by July 1, 2012. Employers may think that, once received, these disclosures may simply be filed away with other plan documents but that could prove to be a costly mistake.
Oct 1, 2012
Victim's Mother May Rely on Post-Amara Equitable Remedies
Check out the latest episode in the sprawling saga of equitable remedies under ERISA. The question, as always, is whether a participant is entitled to something for which the plan document does not expressly provide. This time, the answer appears to be "yes."
Sep 28, 2012
The HIPAA Police Are Here
Recent activity by regulators suggests a trend toward stricter HIPAA enforcement.
Sep 17, 2012
Year-End Amendment Deadline Under Code Section 409A
In the last two years, the IRS has issued several pieces of guidance regarding the correction of deferred compensation arrangements that violate the requirements of Code Section 409A.
Sep 12, 2012
Guidance on "Full-Time" Employees, 90-Day Waiting Period
Starting in 2014, larger employers (generally, those with 50 or more employees) may face "shared responsibility" penalties if any of their "full-time" employees receive subsidized health coverage through an "Affordable Insurance Exchange."
Sep 10, 2012
Grandfathered Status for 2013
"Grandfathered" health plans that have not undergone significant changes since the Patient Protection and Affordable Care Act (PPACA) was enacted in March 2010 will once again have to assess whether the plan can and/or should try to retain such status for 2013.
Sep 4, 2012
MAP-21: Pension Funding Relief -- and Much More
In this case, sponsors of defined benefit pension plans received the funding relief they had sought, but only because the added tax revenues will help pay for transportation projects and prevent student-loan interest rates from doubling.
Aug 16, 2012
Highlights of the Patient-Centered Outcomes / Comparative Effectiveness Fee
Find out what you may need to do to comply with with the patient-centered outcomes provision of the health care reform law.
Aug 13, 2012
Highlights of the New FSA Limits
As enrollment time approaches, employers should be aware of the new contribution limits on flexible spending accounts (FSA) imposed by the health care reform law.
Aug 8, 2012
Highlights of the New SBC Rules for Employers
As enrollment time nears, employers should be aware of the new summary of benefits and coverage (SBC) rules under the health care reform law.
Jul 19, 2012
MLR Rebate Questions and Answers
Find out what you need to know regarding the medical loss ratio (MLR) rebates stemming from the health care reform law.
Jul 2, 2012
Court Rejects 'Equitable Remedies' in SPD Case
In some ways, the Ninth Circuit's recent decision in Skinner v. Northrop Grumman Retirement Plan B is a garden-variety example of a classic fact pattern: The terms of a summary plan description (SPD) promise better benefits than the plan document it summarizes and participants sue for the difference.
Jul 2, 2012
Overview of Medical Loss Ratio Rebates
Medical loss ratio (MLR) rebates are due in August, which means employers should plan how they will handle any rebates they may receive.
Jun 29, 2012
Supreme Court Largely Upholds PPACA
Jun 26, 2012
A Common Mistake: Miscalculating Matching Contributions
Sponsors of 401(k) plans often fail to make the proper employer matching contribution called for under the terms of the plan document. Although there are any number of causes for this failure, a common one involves the timing of matching contributions.
Jun 20, 2012
Preparing for the Supreme Court Decision on Health Care Reform
How the Court rules is anybody's guess. What is certain, however, is that the decision will seriously shape employer-sponsored benefits in the short and long term.
Jun 18, 2012
As Fee Disclosure Deadlines Approach, DOL Issues More Guidance
After more than four years of regulatory starts and stops, plus the threat of a legislative solution, two separate sets of fee disclosure regulations issued by the Department of Labor (DOL) will finally become effective this summer. These regulations will add significant new responsibilities for fiduciaries of ERISA-covered retirement plans, as well as those who provide services to such plans.
Jun 11, 2012
Compliance Brief: New Fees for Health Plans
The health care reform bill created an institute that is charged with advancing research into comparative clinical effectiveness. To fund this institute, the law imposes a fee on both insured and self-funded health plans for the seven-year period from 2012 through 2019.
Jun 4, 2012
IRS Issues Guidance on Implementation of $2,500 Health FSA Limit
The IRS has clarified that the $2,500 limit for health FSAs under the health care reform law does not apply for plan years beginning before 2013.
May 24, 2012
IRS Proposes Methods for Valuing Employer Health Coverage
The IRS has issued three new notices concerning key aspects of the 2010 Patient Protection and Affordable Care Act
May 17, 2012
2013 HSA and HDHP Limits
The IRS has announced new contribution limits for health savings accounts and qualifying high-deductible health plans.
Feb 22, 2012
Compliance Alert: Auto Enrollment, Employer Mandate and Waiting Periods
The federal government has issued a set of frequently asked questions (FAQs) addressing various topics under the Patient Protection and Affordable Care Act.
Feb 14, 2012
Agencies Finalize Guidance on Summary of Benefits and Coverage
Federal agencies have issued a final rule that eased a few requirements on the summary of benefits and coverage (SBC) and moved the deadline to comply.
Feb 6, 2012
DOL Finalizes, Delays 401(k) Fee Disclosure Rules
After months of delay, the Department of Labor (DOL) has just released final regulations under Section 408(b)(2) of ERISA.
Jan 19, 2012
Compliance Alert: More Guidance on W-2 Reporting
The IRS has issued more guidance on W-2 reporting of health care coverage.
Jan 16, 2012
Benefits Briefing: Loss of Privilege Woes
Designating the "company" or "employer" as an ERISA fiduciary can unintentionally subject the employer's executive officers and board of directors to ERISA's fiduciary standards, and potentially to personal liability.
Jan 9, 2012
Benefits Briefing: 'Conflicted' Retirement Advice
A new statutory exemption from the prohibited transaction rules (designed to expand the availability of fiduciary investment advice to participants in individual account plans and IRAs, subject to specific safeguards and conditions) are now in effect.
Jan 3, 2012
Failing to Notify Participants of Plan Changes Can Be Costly
Among ERISA’s many notice and disclosure obligations, the requirement to timely inform participants of important plan changes is one that is too often overlooked.
Dec 28, 2011
Benefits Briefing: Extension of Trade Adjustment Assistance Affects Certain COBRA Coverage
The Trade Act of 2002 created a health care tax credit (HCTC) for certain individuals who become eligible for trade adjustment assistance (TAA eligible individuals), as well as for certain retired employees who are receiving pension payments from the Pension Benefit Guaranty Corporation (PBGC recipients).
Dec 19, 2011
NLRB Passes Limited Version of Election Rule Change
A divided National Labor Relations Board has voted to move ahead with union-backed election rule changes.
Dec 19, 2011
Health Plan Assessed Double Damages for MSP Violation
A federal appeals court has held that the Medicare Secondary Payer (MSP) Act authorizes a medical provider to sue an employer health plan for double damages when the plan fails to comply with the MSP Act.
Dec 12, 2011
Benefits Briefing: Deadlines Approaching for Retirement Plan Amendments
Once again, amendment season is upon us. Sponsors of tax-favored retirement plans should keep in mind the many required amendments for which a year-end deadline is fast approaching.
Dec 5, 2011
Benefits Briefing: Health Care Reform - What Is Going Away?
The tide of regulations interpreting the 2010 Patient Protection and Affordable Care Act (PPACA) began to ebb in 2011, and portions of the law have even been repealed or put on hold.
Oct 25, 2011
2012 Inflation Adjustments for Benefits, Social Security
Oct 13, 2011
NLRB Postpones Deadline for Notice
The National Labor Relations Board has pushed back the deadline for nonunion employers to post a notice on workers' rights to 2012.
Aug 29, 2011
NLRB: Nonunion Employers Must Notify Employees of Their Right to Unionize
The National Labor Relations Board (NLRB) has just issued a final rule obligating the vast majority of private sector employers to notify employees of their rights under the National Labor Relations Act (NLRA).
Aug 25, 2011
New Rules for Benefits Summaries
The federal government has released new rules and forms pertaining to how employers communicate information about group health plans.
Jul 8, 2011
Changes to PPACA Internal, External Review Processes
Group health plans (other than those that are "grandfathered") must comply with a number of internal claims and appeals procedures that go beyond those previously required under ERISA.
Jun 9, 2011
June 30 Deadline for FSA Amendments
As explained in our November 2010 article, last year's Affordable Care Act (ACA) restricted the ability of employer health plans, including flexible spending arrangements (FSAs) and health reimbursement arrangements (HRAs), to reimburse expenses incurred for over-the-counter (OTC) medications.
May 27, 2011
June 30 Deadline for FSA Amendments
With the exception of insulin, expenses for OTC medications may now be reimbursed only if the medications are prescribed by a physician.
May 18, 2011
CMS Revises Medicare Part D Notices
On April 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued revised Medicare Part D creditable and non-creditable coverage notices to reflect an amendment made to the Social Security Act by the Affordable Care Act (ACA).
Apr 28, 2011
Expanded 1099 Reporting Requirements Are Repealed
The final legislation achieves this offset by requiring larger repayments of excess "federal assistance credits" received by individuals who purchase health coverage through one of the ACA's state-wide "Exchanges."
Apr 27, 2011
Budget Compromise Eliminates Free-Choice Vouchers
As a part of the recent compromise allowing for passage of a federal budget for the fiscal year ending September 30, 2011, congressional Republicans succeeded in repealing a significant provision of last year's Affordable Care Act (ACA).