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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. 

July 17, 2012

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decision, Clarcor, Inc. v. Madison National Life Insurance Company, Inc. [2012 WL 3089339 (6th Cir., July 31, 2012) unpublished], reminds us of the importance of plan documentation. 

July 17, 2012

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

July 10, 2012 -- One of the goals of the Affordable Care Act is to incent health insurers to use the bulk of premium dollars for medical services; these provisions are known as the medical loss ratio (MLR) rules.  The following Questions and Answers will attempt to distill a complicated topic into some practical information.

June 27, 2012

HRB 52 - Implementation Guidance on Medicare Tax and Upcoming Supreme Court Ruling on Health Care Reform

June 27, 2012 -- Implementation Guidance on Medicare Tax assessed on High Earners

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)

Prior to 1986, shareholders generally could liquidate a C corporation, or sell all of the assets of a C corporation followed shortly thereafter by a complete liquidation and distribution of the cash received, and pay only one level of tax. 

June 26, 2012

Still Alive and Kickin' (article)

Many states continue to follow the Uniform Division of Income for Tax Purposes Act (“UDITPA”) provisions that establish a “cost of performance” sourcing rule for sales of non-tangible property.  The cost of performance approach often results in an "all or nothing" sales factor allocation yielding both planning opportunities and unanticipated consequences.  As a result, when determining the amount of sales of non-tangible property that should be included in a state’s sales factor numerator, it is important to remember that these provisions are still relevant in many states.

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. 

June 11, 2012

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. 

June 11, 2012

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. 

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