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EEOC Releases Proposed Wellness Regulations

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The Equal Employment Opportunity Commission (EEOC) issued proposed regulations, last week, which set forth the required criteria an employer’s wellness plan needs to satisfy in order to be compliant with the Americans with Disabilities Act (ADA). Interested parties have 60 days to provide comments to the EEOC before the agency finalizes the regulations.
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Categories: Health Care Reform, Compliance, Health Care in General | Tags: Wellness , EEOC , Incentive
Treasury Department guidance requires applicable large employers to reduce their health plan contribution by the amount of any cash paid for not enrolling in the health plan and to not count a flex credit that can be received as cash or used to purchase non-medical care benefits when calculating the affordability of their health plan for a full time employee.
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Categories: Health Care Reform, Compliance | Tags: Report , 1095-C , Large , Play or Pay
In an “extraordinary remedy” the federal district court for the states of Texas, Arkansas, Louisiana and Nebraska issued a preliminary injunction on the enforcement of the Department of Labor’s (DOL’s) rule in those 4 states that was set to go into effect across the country on March 27,2015 that would have provided employees that were legally married elsewhere to same sex spouses and reside in those states with FMLA rights to care for their same sex spouse or that spouse’s family members un...
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Categories: Benefits in General, Compliance | Tags: same sex , marriage , FMLA

SPD Posted on Intranet not Enough

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Employers that are subject to ERISA are required to provide a summary plan description (SPD) to the participants in a health or welfare plan sponsored and maintained by the employer. The SPD can be distributed electronically. However, simply posting the SPD on the employer’s intranet does not satisfy the Department of Labor’s (DOL’s) electronic SPD distribution criteria.
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Categories: Benefits in General, Compliance | Tags: SPD , Plan

FAQ on SBC Published

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In a jointly released Affordable Care Act FAQ, the Department of Labor (DOL) clarifies that the regulators intend to finalize changes in the near future to the summary of benefits and coverage (SBC) templates and glossary of terms applicable for use during open enrollments for health plans renewing on or after January 1, 2016 and for newly eligible employees under those plans.
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Categories: Health Care Reform, Compliance | Tags: SBC

Play or Pay and COBRA

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How does Play or Pay affect the offer of COBRA for an applicable large employer’s (ALE’s) medical plan when a qualifying event occurs? The only COBRA qualifying event that has any interaction with Play or Pay for these ALEs is reduction in hours. If a full time employee has their hours reduced mid-year, the ALE has three (3) options for when to offer COBRA depending on how tolerant the ALE is for the risk of paying a penalty: 1) offer COBRA immediately; 2) wait until the start of the next ...
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Categories: Health Care Reform, Compliance | Tags: COBRA , 1095-C , Measurement , Play , Pay
The IRS has published a Q&A clarifying why insurers are requesting the Social Security numbers of covered participants and their spouses and dependents. The Q&A states that if an individual fails to provide the SSNs that are requested by the insurer that the participant could receive a notice from the IRS that they are liable for the individual shared responsibility payment for not having health coverage.
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Categories: Health Care Reform, Compliance | Tags: Reporting , CMS , 1095-B
Section 1411 of the Affordable Care Act (ACA) establishes the procedures for determining an individual’s eligibility for subsidies from the Health Insurance Marketplace (aka Exchange). Under Treasury Department regulation, a Section 1411 Certification is the certification to an employer that an employee has enrolled in a qualified health plan through the Exchange and been provided a subsidy.
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Categories: Health Care Reform, Compliance | Tags: 1094-C , 1095-C , Report , penalty

CMS Clarifies Cost Sharing Limits for HDHPs

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CMS has clarified, in a Q&A, that high deductible health plans (HDHPs) cannot impose cost sharing for any individual covered by the HDHP that exceeds the individual cost sharing limits established under health care reform. For 2015, the individual cost sharing limit is $6,600.
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Categories: Health Care Reform, Compliance | Tags: HDHP , Limit , Cost Sharing

Court Finds Premium Increase is COBRA Event

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A federal court for the district of Maryland has ruled in favor of two former employees that they should have been offered COBRA when their employer charged them the entire premium to continue coverage while suspended.
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Categories: Benefits in General, Compliance | Tags: COBRA
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