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July 17, 2012
HIPAA Privacy and Security Audit Protocols
The HIPAA privacy and security rules were enacted in 1996, as part of the Administrative Simplification law. They were later amended in 2009 by the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. These rules are intended to ensure protection of individual identifiable medical information, specifically protected health information (PHI). This includes PHI contained both in paper form, and that which is maintained electronically.
Plan Documents Count: Know Their Terms
A recent Sixth Circuit Court decision, Clarcor, Inc. v. Madison National Life Insurance Company, Inc. [2012 WL 3089339 (6th Cir., July 31, 2012) unpublished], reminds us of the importance of plan documentation.
ACA Compliance Audits
Not only is it HIPAA privacy compliance that is being reviewed by the government, but the DOL is making efforts to ensure that health plans comply with the HIPAA portability segment of the law as well. The DOL doesn’t stop there – they are including, in their audits, a review to ensure a plan is compliant with the Affordable Care Act provisions that are in effect. Among these are the requirement to allow dependent children to remain on their parent’s plan until age 26, the requirement to impose no preexisting condition exclusion on a child under age 19, the requirement to impose no lifetime limits on essential benefits, implementation of an internal claims, appeals and external review process, as well as substantiation and disclosure requirements relating to grandfathered health plan status. Clearly it the intent of the government agencies that plans comply with applicable rules.
July 10, 2012
HRB 54 - Medical Loss Ratio Rebates
June 27, 2012
HRB 52 - Implementation Guidance on Medicare Tax and Upcoming Supreme Court Ruling on Health Care Reform
One of the ways expanded access required by the Affordable Care Act (ACA) will be funded is through an increase in Medicare tax for high wage earners. The Medicare tax increase, which takes effect January 1, 2013, imposes a 0.9% increase in the individual’s Medicare tax rate, applicable on earnings in excess of $200,000 in a calendar year. This additional Medicare tax increase does not apply to the employer’s share of the Medicare tax.
June 26, 2012
Somewhere Beyond the C (article)
Still Alive and Kickin' (article)
June 11, 2012
Form W-2 Reporting: The Time to Capture Data is Now
As 2012 approaches its halfway point, it is very important that employers responsible for more than 250 Form W-2s are fully engaged in tracking aggregate health care costs. As background, the health care reform law requires that the aggregate cost of health coverage be reported on the Form W-2. The first reporting requirement applies to 2012 year, due in January 2013.
Multiple Employer Plans Know Where Responsibility Lies
The DOL has recently issued an Opinion Letter (DOL Advisory Opinion 2012-04A - Multiple Employer Plans) clarifying the status of an open multiple employer plan. In these types of arrangements, each employer is sponsoring, according to the Opinion Letter, its own ERISA plan; and, each employer is responsible for its own ERISA compliance, including reporting and disclosure requirements. It is important to remember that if the plan covers more than 100 participants, the Form 5500 must be accompanied by an independent accountant’s audit. While this Opinion Letter specifically addresses a multiple employer plan providing retirement benefits, its message equally applies to a multiple employer welfare arrangement.
Voluntary 403(b) Plans: A Cautionary Note
The DOL has issued an Opinion Letter (DOL Advisory Opinion Letter 2012-02A) relating to 403(b) plans, and when they are deemed to be voluntary and excepted from ERISA.