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Business Insights, Research & Perspectives

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June 7, 2010

Updated Information: Mandatory Medicare Reporting for HRAs

In an effort to ensure that the Medicare Secondary Payor rules are properly administered, the Centers for Medicare and Medicaid Services (CMS) imposed a mandatory reporting requirement on insurers, third party administrators, and plan administrators of self-funded, self-administered health plans, collectively referred to as “Responsible Reporting Entities” (RREs).  The type of information to be reported relates to Medicare beneficiaries who have group health plan coverage.   While this reporting rule became effective January 1, 2009, it is only recently become effective for health reimbursement arrangements (HRAs)(see CMS Clarifies Medicare Mandatory Reporting Requirement for HRAsBenefit Beat, August 2009).  CMS recently issued an Alert updating information relating to the mandatory Medicare reporting for HRAs.  Registration for HRA-only RREs began May 1, 2010 and must be completed by June 30, 2010.  The data submission testing period for HRAs will begin July 1, 2010; production reporting of HRA coverage information will begin October 1, 2010.

May 20, 2010

HRB 4 - The Small Business Health Care Tax Credit

May 20, 2010 -- Small businesses and tax-exempt employers that provide health care coverage to their employees under a qualified health care arrangement may now qualify for a special tax credit starting this year.  Included in the recent health care reform legislation passed in March, the credit is designed to encourage small businesses that employ low and moderate income workers to offer and maintain health insurance coverage for their employees.  To qualify for the credit, the employer must have a plan that requires the employer to contribute at least half the cost of participating employees’ health insurance premiums.   On May 17, 2010, the Internal Revenue Service issued Notice 2010-44, providing additional clarification and guidance for employers regarding the Small Business Tax Credit. 

May 10, 2010

HRB 3 - Health Reform’s Coverage for Dependent Children Explained

May 10, 2010 -- The Patient Protection and Affordable Care Act (“PPACA”) provides that if an individual or group health plan (whether insured or self-funded) provides coverage for dependents, a dependent child must be allowed to remain on the plan until he/she reaches his/her 26th birthday.  This provision in the law takes effect on the first day of the first plan year beginning on or after September 23, 2010 (January 1, 2011 for calendar year plans). 

May 5, 2010

HRB 2 - Early Retiree Reinsurance Program

May 5, 2010 -- The Department of Health and Human Services (HHS) has just issued interim final regulations, and a Fact Sheet, relating to the Early Retiree Reinsurance Program.  This temporary program, established by way of the health care reform laws, provides reimbursement of certain expenses to plan sponsors of group health plans that provide retiree coverage to early retirees, and their eligible spouses and dependents.

May 4, 2010

COBRA Subsidy Extension: Revised Model COBRA Notices and Other Updated Information

In its ongoing effort to assist with COBRA subsidy compliance, the Department of Labor has just issued several documents that have been updated to reflect the extension of the COBRA subsidy eligibly period through May 31, 2010 (seeCOBRA Subsidy Extended….Again!  from the April ’10 Benefit Beat).  Included among these documents are new model notices, discussed below, Application for Expedited Review of Denial of COBRA Premium Reduction, Fact Sheet, and Frequently Asked Questions.

May 4, 2010

Medicare Part D – 2011 Benefit Limits

The Centers for Medicare and Medicaid Services have released the 2011 cost of living adjustments for Medicare Part D prescription drug benefits.  The following are selected modified limits relating to the standard drug benefit and the retiree drug subsidy.

May 4, 2010

A Confidentiality Reminder

It is of upmost importance to ensure the protection of an individual’s medical information.  Several laws address the need to ensure this confidentiality.  HIPAA, for example, addresses protected health information derived from covered entities.  The Rehabilitation Act, the Americans with Disabilities Act (ADA), as well as the Family and Medical Leave Act, also require that medical information be handled with the upmost care.  This issue was highlighted in a recent informal Letter issued by the Equal Employment Opportunity Commission.  The Letter specifically relates to the Rehabilitation Act, but is equally applicable for ADA purposes. 

May 4, 2010

TRICARE Secondary Payor Rules: Final Regulations Issued

The Department of Defense issued final regulations relating to TRICARE secondary payor rules (seeEmployer Coverage? TRICARE? Beware! from the April ’08 Benefit Beat, andNew TRICARE Provisions Affect Group Health Plans from Nov. ’06 Benefit Beat). In summary, these rules are similar to the Medicare secondary payor rules.  If an individual entitled to TRICARE is actively working, the employer cannot do anything to incent the individual to choose TRICARE over the employer’s sponsored health plan.  In other words, the employer cannot, in any way, incent the employee to choose TRICARE, rather than the employer’s plan.  This choice strictly rests with the individual.  Furthermore, an employer is prohibited from paying for a TRICARE supplemental plan.

April 28, 2010

HRB 1 - IRS Guidance: Tax-Favored Status of Dependent Coverage

April 28, 2010 -- As promised, the government is feverishly attempting to issue guidance on the new health care reform law.  Yesterday, the IRS issued guidance relating to the tax-favored status of dependent coverage (IRS Notice 2010-38).  Part of the Reconciliation law (enacted March 30th) provides that reimbursement of health expenses for dependent children who have not attained age 27 by the end of the taxable year (calendar year) is excludable from the employee’s income.  For this purpose, a dependent includes:

April 16, 2010

COBRA Subsidy Extended….Again!

The COBRA subsidy law has been temporarily extended, once again (H.R. 4851, signed by President Obama on April 15, 2010). This is the law that allows individuals involuntarily terminated from employment to pay 35% of the COBRA premium for up to 15 months.

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