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Compliance Recap Nov. 2024 | Wisconsin Benefits Consultants

STATE LEAVE LAW UPDATES MISSOURI On November 5, Missouri voters approved a new law mandating paid sick leave for employees in Missouri. Effective May 1, 2025, the new law applies to private employers of all sizes, with certain exceptions, such as interstate railroad employees, small local newspapers, and retail or service businesses with less than … Continued

Gag Clause Attestation Deadline | Wisconsin Benefits Team

As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit … Continued

Compliance Recap Oct. 2024 | Wisconsin Benefits Firm

MEDICARE PART D CREDITABLE COVERAGE NOTICES Group health plans that provide prescription drug coverage to Medicare Part D eligible individuals must disclose whether that coverage is creditable or not creditable before the start of the annual coordinated election period for Medicare Part D. Creditable coverage means that the coverage is expected to pay on average … Continued

The Pay or Play Percentage Increase for 2025 | Wisconsin Benefits Consultants

The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees.  The affordability rate for employer-sponsored health coverage will increase from 8.39% to … Continued

Compliance Recap Sept. 2024 | Wisconsin Benefits Firm

SUMMARY ANNUAL REPORT DUE The Summary Annual Report (SAR) is a disclosure requirement under ERISA. The SAR acts as a narrative of the Form 5500 for employee benefit plans. It includes financial statements, funding requirements, and participants’ rights. The SAR must be provided to participants and enrolled beneficiaries within nine months after the end of the plan … Continued

Medical Loss Ratio (MLR) Rebates: A Timely Reminder | WI Employee Benefits Team

The Affordable Care Act (ACA) introduced the Medical Loss Ratio (MLR) to ensure that health insurance companies spend a significant portion of premiums on medical care and quality improvement activities rather than administrative costs and profits. When insurers fail to meet the MLR threshold, they are required to issue rebates to plan sponsors. Understanding MLR … Continued

Compliance Recap August 2024 | Wisconsin Benefits Advisors

FEDERAL COURT BLOCKS FTC NON-COMPETE BAN NATIONWIDE: IMPORTANT INSIGHTS FOR EMPLOYERS On August 20, 2024, the U.S. District Court for the Northern District of Texas delivered a crucial ruling, effectively halting the Federal Trade Commission’s (FTC) Rule prohibiting most non-compete agreements. The Rule, which was set to go into effect on September 4, 2024, was … Continued

Compliance Recap July 2024 | WI Employee Benefits Agency

FORM 5500 FILING FOR HEALTH AND WELFARE PLANS The Form 5500 series is a component of the Employee Retirement Income Security Act’s (ERISA) reporting and disclosure framework. The Form is used to report information on the qualification of the plan, its financial condition, investments, and its operations. It also guarantees that participants, beneficiaries, and regulators have access … Continued

Compliance Recap June 2024 | WI Benefits Agents

ACA PREVENTIVE CARE MANDATE REMAINS IN PLACE WITH AN EXCEPTION In a recent decision, the U.S. 5th Circuit Court of Appeals upheld a key provision of the Affordable Care Act (ACA) that mandates private insurance cover preventive services without cost to patients. However, the court also ruled that the plaintiffs are exempt from complying with this mandate, … Continued

Form 5500: What You Need To Know | WI Employee Benefits Team

Attention Employers: Don’t Miss Your Form 5500 Deadline! Here’s a simplified breakdown of what you need to know about filing your employee benefit plan report: Who Needs to File? Employers subject to ERISA (Employee Retirement Income Security Act) with employee benefit plans, unless exempt. What to File? Form 5500 (annual report) for each employee benefit … Continued

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