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Business Insights, Research & Perspectives

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May 12, 2011

Medicare Part D Updates

Change in Medicare Part D Annual Enrollment Period plus New Model Notices of Creditable and Non-Creditable Coverage

May 12, 2011

Update: Wellness Program – ADA Class Action Case

In the April Benefit Beat, a class action lawsuit (Bradley Seff v. Broward County) was mentioned relating to an employer offering financial incentives for participating in a group wellness program.  This case addresses the applicability of the Americans with Disabilities Act (ADA) to wellness programs.  Specifically, a group of employees challenged the employer’s imposition of a wellness program that requires completion of a health risk assessment (HRA).  Failure to complete the HRA would result in a financial penalty.  The complainant alleged that this was a violation of the ADA because it impermissibly requested medical information.  Generally, the ADA permits the collection of medical information as long as it is voluntary.  The “voluntary” nature of the medical information collection was in question. 

May 11, 2011

The Outlook for Major Tax Reform: What You Need to Know

A bruising budget battle, near-government shutdown, lightening-rod speech by President Obama, and threatened downgrade in the AAA rating of US debt all added to the momentum for major tax reform in the first few weeks of April 2011. At this point, the calls for tax reform are intertwined with efforts to reduce the federal deficit, and some of the proposals in process are more sweeping than we have seen in decades.

April 18, 2011

HRB 34 - Repeal of Free-Choice Vouchers and Form 1099 Reporting

April 18, 2011 --  Two laws have recently been passed that impact the Patient Protection and Affordable Care Act (PPACA).  Both laws relate to the repeal of certain aspects of health care reform law.  One law relates to the repeal of the free-choice voucher provision; and, the second law repeals the Form 1099 reporting requirement.

April 5, 2011

ADAA Regulations Issued – Discrimination is the Focus

The ADA Amendments Act of 2008 (ADAA) was enacted September 25, 2008.  This law amended the Americans with Disabilities Act (ADA) which became law on July 26, 1990 (see ADA Amended from the October, 2008 Benefit Beat).  On March 25, 2011, final regulations implementing the ADAA were issued.  These regulations become effective on May 24, 2011. 

April 5, 2011

Financial Incentives for Wellness Program Participation: Employers Beware

The increased use of wellness programs raises issues relating to the Americans with Disabilities Act (ADA) (see Health Risk Assessments: Where Do They Stand? from the June 2009 edition of the Benefit Beat).    The potential risk can arise in a couple ways, such as inquiring about non-job related disability, or making coverage under a health plan contingent upon completing a health risk assessment.  The EEOC has not provided formal guidance on this matter; however, have issued two informal opinions. 

April 4, 2011

HRB 33 - Grandfathered Status and ERRP Updates

April 4, 2011 --  Agencies Issued New FAQs:  Grandfathered Status

The Agencies (DOL, HHS and IRS) have recently issued some additional sub-regulatory guidance relating to the Patient Protection and Affordable Care Act in the form of Frequently Asked Questions.  These 6 new FAQs relate primarily to determining grandfathered status as follows:

March 30, 2011

HRB 32 - IRS Issues Interim Guidance on W-2 Reporting

March 30, 2011 --  One of the provisions of the Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of health coverage on the employee’s Form W-2.  This reporting requirement is informational-only, and does not create a taxable event.  This provision was to be applicable for the 2011 reporting year; generally, for the W-2 required in January, 2012.  In IRS Notice 2010-69 issued in October, 2010, the requirement was made voluntary for 2011 (see IRS delays W-2 reporting of employer health coverage from the CBIZ Health Reform Bulletin,

March 22, 2011

HRB 31 - Delay in Claims and Appeals Enforcement

March 22, 2011 --  One of the provisions of the Patient Protection and Affordable Care Act (PPACA) is the expansion of the internal claims and appeal, and external review rules.  The PPACA not only augments the internal claims and appeals rules applicable to ERISA plans by adding an external review requirement, among other things, but it also extends these rules to plans exempt from ERISA, such as state and local government plans, and church plans.  These rules apply to non-grandfathered plans (those not in existence on 3/23/10), as well as to plans that lose grandfathered status.  

March 2, 2011

Marriage - Where Does It Stand?

Even without a full blown philosophical discussion of the meaning of marriage, the issues surrounding this concept are fraught with uncertainty.  On February 23, 2011, in a letter to John Boehner, Speaker of the U.S. House of Representatives, and by an Official Statement, Attorney General Eric Holder, on behalf of the Department of Justice (DOJ), indicated that the DOJ will no longer defend the Defense of Marriage Act (DOMA).  DOMA is a federal law, enacted in 1996 (codified at 1 U.S.C. §7 and 28 U.S.C. §1738C), that defines marriage as, “a legal union between one man and one woman as husband and wife, and the word “spouse” refers only to a person of the opposite sex who is a husband or a wife”.

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