Archives: Compliance

Compliance Recap January 2024

February 19, 2024 | By Cleveland Benefits Partners

NEW EMPLOYEE CLASSIFICATION RULE In January, the Department of Labor (DOL) Wage and Hour Division introduced a rule that changes the way workers are classified under the Fair Labor Standards Act (FLSA). This Final Rule, effective March 11, 2024, offers a more comprehensive test to determine a worker’s status, potentially making it more challenging to classify • Read More »

Compliance Recap December 2023

January 23, 2024 | By Cleveland Benefits Partners

WORKPLACE POSTERS The U.S. Department of Labor (DOL) enforces the posting of employee notices in the workplace to comply with various DOL statues. The posters are available for free in multiple languages. To determine which posters are needed for your business, the DOL  FirstStep Poster Advisor can help. Employers can download and print the posters directly from • Read More »

Compliance Recap November 2023

December 18, 2023 | By Cleveland Benefits Partners

NEW ACA FAQS RELEASED The Affordable Care Act (ACA) Implementation FAQ Part 63, issued by the U.S. Departments of Labor, Health and Human Services, and the Treasury focuses on the Public Health Service Act, which mandates that non-grandfathered group health plans and health insurance issuers provide culturally and linguistically appropriate summaries of benefits and coverage (SBC) • Read More »

Compliance Recap October 2023

November 8, 2023 | By Cleveland Benefits Partners

ADJUSTED CIVIL PENALTIES The U.S. Department of Health and Human Services (HHS) has recently announced adjustments to civil penalties related to violations of the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Secondary Payer (MSP) rules. These penalty adjustments take into account inflation and are applicable to violations • Read More »

Compliance Recap August 2023

September 19, 2023 | By Cleveland Benefits Partners

IRS DECREASES 2024 ACA AFFORDABILITY TO 8.39% The IRS has announced a reduction in the Affordable Care Act (ACA) affordability percentage for plan years starting in 2024, lowering it from 9.12% in 2023 to 8.39%. This affordability percentage determines the maximum portion of an employee’s household income that can be spent on self-only coverage while still complying • Read More »

Compliance Recap July 2023

August 24, 2023 | By Cleveland Benefits Partners

PROPOSED CHANGES TO SHORT-TERM, LIMITED-DURATION INSURANCE On July 7, 2023, the U.S. Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury proposed changes to modify the definition of short-term, limited-duration insurance (STLDI) and the conditions for fixed indemnity insurance to be considered an excepted benefit. The • Read More »

Compliance Recap -June 2023

July 27, 2023 | By Cleveland Benefits Partners

PCORI FEE DUE DATE APPROACHES Employers offering self-funded medical plans, including health reimbursement arrangements (HRAs) must report and pay fees to the Patient-Centered Outcomes Research Institute (PCORI) by July 31. If the plan was fully insured, employers can rely on their insurance carriers to handle the fee payment. The current annual fees are: For plan years • Read More »

Compliance Recap May 2023

June 22, 2023 | By Cleveland Benefits Partners

CLAIMS SUBSTANTIATION FOR PAYMENT OR REIMBURSEMENT OF MEDICAL AND DEPENDENT CARE EXPENSES A memorandum released by the IRS Chief Counsel responds to a request for assistance regarding the reimbursement of medical and dependent care expenses. Addressed is whether reimbursements of medical expenses from a health flexible spending arrangement (FSA) provided in a cafeteria plan should • Read More »

Compliance Recap April 2023

May 23, 2023 | By Cleveland Benefits Partners

2024 BENEFIT PARAMETERS FOR MEDICARE PART D CREDITABLE COVERAGE DISCLOSURES ANNOUNCED The Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D. These factors are used to determine the actuarial value of defined standard Medicare Part D coverage under CMS guidelines. Each year, Medicare Part D requires • Read More »

Compliance Recap – March 2023

April 10, 2023 | By Cleveland Benefits Partners

IRS RELEASES 2024 EMPLOYER SHARED RESPONSIBILITY PROVISION PENALTIES The dollar amount used to calculate the employer shared responsibility provision penalties (ESRP) has been provided for 2024. As background, the penalties can be assessed under Code § 4980H(a) if an applicable large employer (ALE) fails to offer minimum essential coverage to the required number of full-time • Read More »

Two Areas Impacting Benefits When the COVID-19 Emergencies End

April 4, 2023 | By Cleveland Benefits Partners

When the COVID-19 public health emergency and national emergency were declared in 2020, no one anticipated they would still be in place in 2023. On January 30, 2023, the President announced the intent to end the emergencies on May 11, 2023. The impact of the emergencies on employer-sponsored benefits affected certain coverages, reimbursements, and timelines. • Read More »

PCORI fees are due by Monday, August 1, 2022

July 18, 2022 | By Cleveland Benefits Partners

By way of background, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to study clinical effectiveness and health outcomes. To finance the Institute’s work, a small annual fee—commonly called the PCORI fee—is charged on group health plans. Grandfathered health plans are not exempt. Most employers do not have to take any • Read More »

Transparency Rules Require Plan Sponsors to Act Now Before July 1 Deadline

May 4, 2022 | By Cleveland Benefits Partners

The Departments of Health and Human Services, Labor, and Treasury (the Departments) released Transparency in Coverage (TiC) rules in late 2020 that will require fully insured and self-funded plan sponsors of non-grandfathered group health plans to make important disclosures about in-network and out-of-network rates beginning July 1, 2022. To be ready to meet that deadline, • Read More »