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October 13, 2011
Medicare Mandatory Reporting for HRAs: Increased Threshold Levels and Exhausted Account Balances
As a means of enforcing the Medicare Secondary Payer (MSP) Rules, the Centers for Medicare and Medicaid Services (CMS) impose a reporting requirement upon insurers, third party administrators, and plan administrators of self-funded, self-administered group health plans. CMS considers health reimbursement arrangements (HRAs) to be a group health plan for purposes of the MSP rules; and thus, subject to the Medicare Mandatory Reporting Requirement (see prior Benefit Beat articles, Mandatory Medicare Reporting for HRAs Clarified, Aug, 2010, and Updated Information: Mandatory Medicare Reporting for HRAs, June, 2010).
Should You Re-Classify Your Employees?
Employment classification has created much angst between government agencies, both federal and state, and employers. At the heart of this conflict is whether an individual should be classified as an independent contractor, or as an employee. Contrary to popular belief, an employer does not necessarily have the discretion to classify employees as independent contractors, or as common law employees; rather, it is determined by the facts and circumstances of the work relationship.
August 30, 2011
Expiration of COBRA Subsidy
The COBRA premium assistance subsidy ended May 31, 2010, and has not been reinstated. Therefore, individuals who were involuntarily terminated after May 31, 2010, do not qualify for the subsidy. However, individuals who qualified for the subsidy on or before May 31, 2010 could continue to pay reduced premiums for the full subsidy period (15 months), as long as they are not eligible for another group health plan or Medicare. For employees who elected the subsidy in May 2010, and had no access to other health coverage since, their 15 months of COBRA premium subsidies expired at the end of August 2011. There may be some additional months of subsidy available in the limited situations in which a qualifying event on or before May 31, 2010, but COBRA did not commence until some date thereafter.
Keeping Medical Information Confidential
What can employers do with medical information, particularly medical information that is protected by the Americans with Disabilities Act (ADA) or the Genetic Information Nondiscrimination Act (GINA), is an open-ended question. The Equal Employment Opportunity Commission (EEOC) is the division of the Department of Labor responsible for administering both the ADA and GINA. The EEOC has recently issued two informal, non-binding Opinion Letters expressing some thoughts on these matters.
Reminder: Change in Medicare Part D Open Enrollment Period
As mentioned earlier this year (see Medicare Part D Updates, Benefit Beat, May 2011), the health care reform law changed the Medicare Part D annual enrollment period. Beginning this year, the Medicare Part D enrollment period will take place from October 15, 2011 through December 7, 2011. Therefore, all Medicare Part D notices of creditable or non-creditable coverage must be provided prior to October 15, 2011. CMS issued revised model Notices of Creditable and Non-Creditable Coverage to be used on or after April 1, 2011, in both English and Spanish:
Updated Medicaid/CHIP Premium Assistance Notice Issued
Individuals who are eligible for employer-sponsored group health coverage, but are unable to afford the premium, may be eligible to receive premium assistance from a state’s Medicaid agency or CHIP program. Employers are required to provide premium assistance information to their employees. This can be accomplished by using a model notice provided by the Department of Labor (see Medicaid/CHIP Premium Assistance Notice Issued, Benefit Beat, 3/4/10). The DOL has recently released its revised Medicaid/CHIP notice that can be obtained from its website (click here for 7/31/11 version).
August 23, 2011
HRB 39 - Relief for Stand-Alone Health Reimbursement Arrangements
August 18, 2011
HRB 38 - Proposals on Exchanges, Premium Assistance and Uniform Benefit Summary
August 8, 2011
Extension for Self-Reporting of Welfare Benefit Plan Violations
For the past two years, it has been incumbent upon employers sponsoring group health plans, as well as certain other responsible entities, such as insurers or third party administrators, to self-report certain welfare benefit plan violations (see Welfare Benefit Plan Violations: Self-Reporting Required from the November 2009 Benefit Beat). Such violations would include those relating to:
San Francisco HCSO Expenditure Rates for 2012
Covered employers who are subject to San Francisco’s Ordinance are required to make health care expenditures (HCE) to, or on behalf of, their covered employees. These expenditure amounts are adjusted annually, in accordance with the San Francisco Ordinance. Nonprofit entities with fewer than 50 employees, and small employers (those with fewer than 20 employees) are exempt from these provisions.