Employee Benefits Compliance Resource Center

Our employee benefits compliance experts regularly examine state & federal insurance regulations to keep our clients from incurring costly fees or penalties. The Employee Benefits Compliance Resource Center is a repository of new laws/regulations, expert guidance and insightful news articles, where HR & Finance professionals gain actionable information for their benefit programs.

11.11.2019 | Compliance Alert!

IRS Announces Health FSA and Other 2020 Limits​
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Resources

Below are our compliance resource postings over the last 6 months. For your convenience the sections are color-coded in chronological order. Orange Compliance Alerts discuss new guidance interpreted by our staff ERISA attorney and team. U.S. Policy postings represent new state and Federal laws and In the News articles convey current commentary from reputable news outlets.

U.S. Policy

IRS Issues New Contribution Limits For Health FSAs and Other Plans
11.6.2019  — For 2020, employees can contribute $2,750 to health FSAs, up from $2,700 in 2019. The same increase applies to limited-purpose FSAs (i.e., dental and vision), which can be stacked with health savings accounts. The IRS has also increased monthly exclusion amounts for Commuter Benefits to $270 in 2020 (up from $265 in 2019) and for Adoption Assistance to $14,300 in 2020 (up from $14,080 last year).
IRS Rev. Proc. 2019-44 »

Compliance Alert

California Requires New FSA Notices in 2020​​​

10.11.2019
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U.S. Policy

Proposed Rules Released For 2 New Types of HRAs—ICHRAs and EBHRAs
09.27.2019 — Complying with the ACA Employer Mandate requirements and Internal Revenue Code nondiscrimination requirements, the Rules propose that the cost of an affordable plan at an employee’s primary site of employment is a reasonable proxy for the cost of an affordable plan at the employee’s residence. So, an employer may use the lowest cost silver plan for employee self-only coverage, where the employee’s primary site of employment is located, for determining whether an offer of an ICHRA to a full-time employee is affordable.
Federal Register »

U.S. Policy

Washington, D.C. Issues Information Reporting Guidance on Its Individual Mandate Law
08.09.2019 — The law generally requires employers that covered at least 50 full-time employees, including at least one employee who was a D.C. resident, to file returns with the city.
D.C. Individual Mandate Guidance »

In The News

HHS Announces New Plan for Safe Rx Importation
07.31.2019 — The HHS and FDA are publishing a Safe Importation Action Plan laying the foundation for the safe importation of certain prescription drugs.
HHS Press Release »
Safe Importation Action Plan » (.pdf)

Compliance Alert

New Jersey Issues Guidance on its Individual Mandate Reporting Requirements; Extends Reporting Deadline​

07.29.2019
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In The News

Proposed Regulation Would Require Hospitals to Publish Rates Negotiated with Insurers 07.29.2019 — The Centers for Medicare & Medicaid Services (CMS) proposed new regulations designed to improve healthcare price and quality transparency. 
CMS News Release »
Proposed Regulation »

In The News

AARP Foundation Sues Yale University Over Employee Wellness Program
07.17.2019 — The class action suit alleges that the program, which involves workers undergoing certain medical examinations and divulging health info in lieu of a weekly fine, is a violation of the American with Genetic Information Nondiscrimination Act.
Yale’s Wellness Program Plan Guide »
The Complaint »
Med City News »

In The News

House is Set to Vote on Healthcare Cadillac Tax Repeal
07.15.2019 — On Wednesday, July 17, 2019, the House plans to vote on legislation that would roll back the Affordable Care Act’s Cadillac tax. The 40% surcharge tax applies to certain high-cost employer healthcare plans.
Roll Call »

U.S. Policy

Final Rule on HRAs Could Shake Up Markets
06.20.2019 — A new rule that expands the use of health reimbursement arrangements (HRAs) changes the health insurance landscape with potential implications for employers, insurers and patients.
Health Affairs »
Final Rule »

U.S. Policy

Court Issues New Nationwide Injunction On Contraceptive Mandate
06.13.2019 — When considered in light of other recent court decisions, the injunction increases ambiguity about how employers with religious objections to birth control would comply with the ACA Contraceptive Coverage Mandate.
Health Affairs »
ACA Summary Judgment »

Compliance Alert

New York Paid Family Leave Contributions and Benefits Set to Increase January 1, 2020​​​

10.23.2019
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U.S. Policy

HHS Rescinds HIPAA Health Plan Identifier Rules
10.20.2019  — In final regulations, the Department of Health and Human Services has rescinded earlier rules governing health plan identifiers (and their related implementation specifications and requirements), which were intended for use in standard electronic transactions under HIPAA. The final regulations are effective December 27, 2019.
Thomson Reuters »

In The News

Record High Medical Loss Ratio (MLR) Rebates
09.26.2019 — Many more or our clients are getting MLR rebates this year, and they’re for much larger sums of money than we’ve seen. This is likely happening now due to the high profitability of insurance companies, particularly in the individual insurance markets.
Kaiser Family Foundation »
Kaiser Family Foundation Individual Insurance Market Performance in 2018 »

In The News

Medicare for All Tax Impact Gets Attention at Democratic Debate
07.30.2019 — One particular aspect of Bernie Sanders’ Medicare for All plan got special scrutiny: whether candidates would raise taxes and whether families’ total healthcare bills would go up. 
NPR Health »

In The News

Here are the Democrats’ Three Key Disputes About Medicare for All
07.31.2019 — During the Democratic presidential debate, the party’s moderates worked to undermine the liberals’ plan for a national health insurance system.
Washington Post »

In The News

Trump Administration Plans to Allow Some Imported Rx Drugs from Canada
07.31.2019 — The administration is outlining two possible ways certain drugs that were intended for foreign markets could be imported to the U.S.
NPR Health »

U.S. Policy

Three Updates on State Individual Mandate Healthcare Laws:
07.19.2019 New Jersey Issues Guidance on Individual Mandate Reporting Rules/Requirements
NJ.gov »

07.12.2019  Rhode Island Passes Requirement for Residents to Have Health Insurance
Taxnews.ey.com »

06.27.2019  California Legislature Passes Health Insurance Individual Mandate Penalty
ca.gov »
Californiaglobe.com »

In The News

House Passes Bill to Repeal the Cadillac Tax 07.17.2019 — The U.S. House of Representatives approved the “Middle Class Health Benefits Tax Repeal Act of 2019,” which would fully repeal the “Cadillac Tax.” The strong bipartisan vote of 419 to 6 underscores both the importance and urgency of full repeal.
Washington Post »
Read the Bill here.

U.S. Policy

Trump Administration Issues Executive Order on Healthcare Price Transparency
06.25.2019 — The Executive Order instructs the DOL, HHS and Treasury to issue guidance on surprise medical bills, high-deductible health plans, health savings accounts, and expenses related to direct primary care arrangements and healthcare sharing ministries. Health Affairs »

Compliance Alert

Agencies Issue Final Regulation Expanding HRA Uses and Availability​
06.18.2019
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Compliance Alert

Reminder: Seventh Year of PCOR Fees Due July 31, 2019​
06.06.2019
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Compliance Alert

Reminder: 2nd Year of Massachusetts Health Insurance Reporting Form Due November 30​

10.23.2019
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Compliance Alert

IRS and Treasury Issue Proposed Regulation on New "ICHRAs" Available in 2020

10.15.2019
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Compliance Alert

REVISED IRS Allows New Expenses for Chronic Conditions to Be Treated as Preventative Care under HSA Rules​​

9.20.2019 revised from 07.22.2019
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U.S. Policy

CA Notification of Deadline to Withdraw Funds from FSAs
8.30.2019 — Effective January 1, 2020 a new labor law requires employers with workers in California to notify their flexible spending account (FSA) participants about any deadline to withdraw funds from the FSA (whether a health FSA, dependent care FSA (or DCAP) or an adoption assistance FSA) before the end of the plan year. The law requires that the employer provide the notice through 2 different channels, which can include postal mail, emails, texts, phone calls and in-person notification.
California Legislative Information »

U.S. Policy

IRS Lowers ACA Affordability Percentage for 2020
07.25.2019 — Employer-sponsored health coverage will satisfy the ACA’s affordability requirement if the lowest-cost, self-only coverage option available to employees does not exceed 9.78% of household income.
SHRM »
IRS Revenue Procedure »

Compliance Alert

IRS Lowers ACA Affordability Percentage for 2020; Applies New Method for Determining Annual Percentage Adjustment

07.29.2019
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U.S. Policy

IRS Expands Preventive Care Benefits List for HSA Participants
07.17.2019 — The Internal Revenue Service has added care for a range of chronic conditions to the list of preventive care benefits that may be provided by a high deductible health plan (HDHP). Notice 2019-45 (PDF), posted on IRS.gov, lists the new types of medical care that may be treated as preventive care for this purpose.
IRS.gov »

Compliance Alert

Agencies Directed to Issue Rules on Healthcare Price and Quality Transparency​​
07.01.2019
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In The News

Injunction Against Contraceptive Regulation Upheld
07.16.2019 — On July 12th the Third Circuit Court of Appeals upheld a preliminary nationwide injunction against two rules to dramatically expand exemptions to the ACA’s contraceptive mandate based on religious or moral objections.
Health Affairs »
Read the Court’s decision here.

U.S. Policy

Trump Administration Issues Executive Order on Healthcare Price Transparency
06.25.2019 — The Executive Order instructs the DOL, HHS and Treasury to issue guidance on surprise medical bills, high-deductible health plans, health savings accounts, and expenses related to direct primary care arrangements and healthcare sharing ministries. Health Affairs »

U.S. Policy

An Examination of the Current Status of State Individual Mandate Laws
06.13.2019 — Brookings Institution takes a closer look at each of the laws in the jurisdictions that have enacted them: New Jersey, Vermont, Washington, D.C. and Massachusetts.
Center for Health Policy at Brookings »

Compliance Alert

IRS Issues 2020 HSA Limits
05.30.2019
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