Determining COBRA Premiums for Fully Insured and Self Funded Health Plans

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Determining COBRA Premiums for Fully Insured and Self-Funded Health Plans The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. While some group health plans may provide COBRA continuation coverage at a reduced rate or at no cost, most qualified […]

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COBRA Notices

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The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires group health plans to provide notices to covered employees and their families explaining their COBRA rights when certain events occur. The various notices described below are subject to different timeframes and requirements under COBRA. Initial Notice The initial notice, also referred to as the general […]

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Compliance Recap // June 2017

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June was an active month in the employee benefits world. The U.S. Senate released a draft of the Better Care Reconciliation Act of 2017 which would substitute the U.S. House Resolution 1628 that aimed to repeal and replace the Patient Protection and Affordable Care Act (ACA). The U.S. Supreme Court decided an ERISA church plan […]

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Compliance Alert – PCORI Fee due July 31 – Form 720

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Employer action is required if you maintain a self-funded plan and/or a standalone Health Reimbursement Arrangements (HRA) associated with a fully insured and/or self-funded plan.  If you have a fully insured health plan and do not have an HRA, you may disregard, as the insurance carrier is responsible for this reporting.   The Patient-Centered Outcomes Research […]

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Frequently Asked Questions about Employees’ Reduction in Hours

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The Section 125 cafeteria plan regulations and the Patient Protection and Affordable Care Act (ACA) require employers to take certain actions when an employee reduces hours. Below are answers to some common questions. Coverage During a Stability Period Q1: An employer has an employee who is reducing hours below 30 hours per week. The employee […]

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IRS Updates

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IRS Updates Health Coverage Affordability Calculation for Individuals for 2018 The Internal Revenue Service (IRS) issued Revenue Procedure 2017-36, adjusting the calculation determining whether an individual can afford employer-sponsored health coverage, which affects whether the individual would be eligible for a premium tax credit on the public health exchanges. This could affect employers who are […]

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ACA Market Stabilization Final Rule

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On April 18, 2017, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) published its final rule regarding Patient Protection and Affordable Care Act (ACA) market stabilization. The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the […]

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