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Uniform Coverage and the Health FSA

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The Uniform Coverage Rule requires that “the maximum amount of reimbursement from a health FSA must be available at all times during the period of coverage (properly reduced as of any particular time for prior reimbursements for the same period of coverage).” Prop. Treas. Reg. §1.125-5(d)(1).
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Categories: Benefits in General, Compliance | Tags: Health FSA , Uniform Coverage Rule

HIPAA Special Enrollment Rights

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The Health Insurance Portability and Accountability Act ("HIPAA") provides certain special enrollment rights for group health plan participants when a participant gets married, has a new child through birth, adoption or placement for adoption, or loses coverage due to their spouse’s or dependent’s loss of coverage.
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Categories: | Tags: HIPAA

Health Care Reform Headed to Supreme Court

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In August, the Eleventh Circuit Court of Appeals rejected the individual mandate provision of the Obama administration’s health care reform law, that everyone must purchase insurance or be covered by an employer’s group health plan, as a “wholly novel and potentially unbounded assertion of congressional authority,” but upheld the rest of the law. The Eleventh Circuit was one of three federal courts of appeal that have issued decisions on the law so far – all reaching different conclusions....
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Categories: Health Care Reform | Tags:

2011 – 2012 IRS Project Plan

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The IRS released their project plan for 2011-2012. The plan includes items that the IRS and Treasury would like to address. Here are some of the items in the plan that impact employee benefits:
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Categories: Benefits in General | Tags:
Wisconsin recently amended state insurance statute 632.885 to conform to federal regulation that requires health plans to cover eligible children at least to age 26. The new state law is effective as health insurance plans renew on or after January 1, 2012.
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Categories: | Tags: cobra , dependent

MLR’s Potential Effect on HRAs and HSAs

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The Patient Protection and Affordable Care Act (PPACA) contains Medical Loss Ratio (MLR) provisions that require insurance companies to spend at least 80% of revenue on health care for small employers and 85% of revenue for large employers. If the insurance company fails to meet these new standards, the new provision will require the insurance companies to provide a rebate beginning in 2012.
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Categories: Health Care Reform | Tags: Medical Loss Ratio , HSA , HRA

Four-Page Summary of Benefits & Coverage

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Beginning March 12, 2012, health care reform requires group health plans to provide a four-page summary of benefits and coverage (SBC) and access to a separate glossary with uniform definitions of specific medical and coverage-related terms to all eligible individuals. The goal of the SBC is to provide consumers with access to information in plain English to help them understand the coverage they have or the differences in the coverage and benefits by health plans when they are shopping for a n...
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Categories: Health Care Reform | Tags: Four-Page Summary

HRA Annual Benefit Limit - No Waiver Required

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As the third party administrator of Health Reimbursement Arrangements (HRAs), we have closely followed the implementation of various provisions of the Patient Protection and Affordable Care Act (PPACA), better known as Health Care Reform, and how those provisions might impact the plans we offer.
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Categories: Health Care Reform | Tags: HRA , Annual Limits , Waiver
While it's no big secret that as your plan year ends, nondiscrimination testing must be completed. The mystery begins as you try to assimilate the rules and regulations required to successfully complete the Nondiscrimination Testing Worksheet.
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Categories: Compliance | Tags: Nondiscrimination Testing

Alphabet Soup of Benefits: HSAs, HRAs and FSAs

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According to Investment News, health savings account (HSA) balances and the number of HSAs jumped this past summer as employers continued to implement high deductible health plans (HDHPs). Health care reform and the lagging economy seem to be impacting interest in HDHPs and consequently, HSAs. In light of such interest, a quick review of HSAs and a comparison to other common benefit offerings – health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs) – is in order.
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Categories: Benefits in General | Tags: Health Savings Account