ACA REPORTING Affordable Care Act (ACA) reporting for applicable large employers (those with 50 or more employees) was due for the 2024 plan year in March. Reporting to Employees – due March 3, 2025 Form 1095-C: For Applicable Large Employers (ALEs) to report health coverage offered to full-time employees. Form 1095-B: For employers with self-funded … Continued
RESULTS OF AGENCY ENFORCEMENT OF MHPAEA INVESTIGATIONS The U.S. Departments of Labor (DOL) and Health and Human Services (HHS) recently released their latest enforcement findings on the Mental Health Parity and Addiction Equity Act (MHPAEA), covering investigations completed during the 2023-2024 fiscal year. Their report sheds light on key areas of noncompliance and emphasizes the government’s ongoing … Continued
IRS ISSUES TAX GUIDANCE ON STATE PAID FAMILY AND MEDICAL LEAVE PROGRAMS On January 15, 2025, the Internal Revenue Service (IRS) released Revenue Ruling 2025-4 (providing guidance on the taxation and reporting of contributions and benefits under state paid family and medical leave (SPFML) programs. Key Highlights Employer and Employee Contributions Employee-required SPFML contributions paid by an … Continued
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
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
FEDERAL TRADE COMMISSION BANS NON-COMPETE CLAUSES On April 23, 2024, the Federal Trade Commission (FTC) finalized a rule banning most employers and employees from entering into non-compete clauses, effective 120 days post-publication in the Federal Register. This move aims to eliminate these clauses across all levels of workers, with a narrow exception for senior executives’ pre-existing agreements. … Continued
NEW EMPLOYEE CLASSIFICATION RULE In January, the Department of Labor (DOL) Wage and Hour Division introduced a rule that changes the way workers are classified under the Fair Labor Standards Act (FLSA). This Final Rule, effective March 11, 2024, offers a more comprehensive test to determine a worker’s status, potentially making it more challenging to classify … Continued
NEW ACA FAQS RELEASED The Affordable Care Act (ACA) Implementation FAQ Part 63, issued by the U.S. Departments of Labor, Health and Human Services, and the Treasury focuses on the Public Health Service Act, which mandates that non-grandfathered group health plans and health insurance issuers provide culturally and linguistically appropriate summaries of benefits and coverage (SBC) … Continued
ADJUSTED CIVIL PENALTIES The U.S. Department of Health and Human Services (HHS) has recently announced adjustments to civil penalties related to violations of the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Secondary Payer (MSP) rules. These penalty adjustments take into account inflation and are applicable to violations … Continued
IRS DECREASES 2024 ACA AFFORDABILITY TO 8.39% The IRS has announced a reduction in the Affordable Care Act (ACA) affordability percentage for plan years starting in 2024, lowering it from 9.12% in 2023 to 8.39%. This affordability percentage determines the maximum portion of an employee’s household income that can be spent on self-only coverage while still complying … Continued
