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Third Quarterly Newsletter of 2016

Below please find our Compliance Observer Newsletter for the third quarter of 2016. This newsletter contains information on many employee benefits compliance issues. The following articles, information, and important reminders are contained in this Newsletter: Medicare Part D Notices are due by October 14th Final Nondiscrimination Standards under ACA Section 1557 IRS Finalizes Regulations Implementing Same-Sex Marriage Decisions and Guidance Proposed Notice of Benefit & Payment Parameters for 2018 Health Savings Account (HSA) Eligibility Rules ACA Reporting – Section 6055/6056 3rd Quarter Newsletter 2016

Newsletters

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Year End Compliance Requirements & Deadlines

Key benefit requirements and deadlines for 2016. September Summary Annual Report (SAR) – A narrative summary of your Form 5500, including a statement of the right to receive the annual report, must be distributed to plan participants by the last day of the ninth month following the end of the plan year, by September 30th for calendar year plans. Plans that have an extension of time to file the Form 5500 must provide the SAR within two months after the extension. MLR Rebates – Deadline for issuers to pay medical loss ratio (MLR) rebates to plan sponsors is September 30th….

DOL Increases Penalties for Health Plan Violations

Applies to: All Employers Background The 2015 Bipartisan Budget Act (the “Act”) includes provisions to strengthen the civil monetary penalties under various federal laws, including the Employee Retirement Income Security Act (“ERISA”). Pursuant to the Act, the Department of Labor (“DOL”) must adjust ERISA’s civil monetary penalties by instituting: An initial ‘‘catch-up’’ increase to the penalty amounts, effective Aug. 1, 2016; and Subsequent annual adjustments for inflation, beginning in January 2017. In response to the Act, on July 1, 2016, the DOL issued an interim final rule that increases the civil penalty amounts that may be imposed under ERISA and…

Appeal of Exchange Subsidy Notices

Applies to: All Employers As previously addressed in our 2nd Quarter Compliance Observer Newsletter, beginning this spring the Department of Health and Human Services (HHS) announced that it would begin sending Exchange subsidy notices to employers who had an employee(s) enroll in health coverage through the Marketplace and who were deemed eligible for a subsidy at the time of application. If you are an applicable large employer (ALE), defined as an employer with 50 or more full-time employees, including full-time equivalents, this notice and the determination provided therein does not establish whether you are liable for an Employer Shared Responsibility…

HHS Issues Rule on Nondiscrimination in Health Programs

On May 13, 2016, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued the Final Rule titled “Nondiscrimination in Health Programs and Activities,” which prohibits discrimination under Section 1557 of the Affordable Care Act (ACA). HHS states that the purpose of this rule is to “help advance equity and reduce health disparities by protecting some of the populations that have been most vulnerable to discrimination in the health care context.” Specifically, under the rule, individuals may not be discriminated against in health care on the basis of race, color, age, national origin, disability, or sex.”…

DOL Issues New Overtime Payment Rules

Highlights of Final Rule * The salary level for administrative, executive and professional employee exemptions will increase to $47,476 * The salary level for the highly compensated employee exemption will increase to $134,004 * The final rule does not change the duties test for white color exemptions * Employers will need to comply with this rule by December 1, 2016   On May 18, 2016, the U.S. Department of Labor (DOL) announced a final rule regarding overtime wage payment qualifications for the “white collar exemptions” under the Fair Labor Standards Act (FLSA). The final rule increases the salary an employee…

EEOC Issues Final Rules on Employer Wellness Programs

The Equal Employment Opportunity Commission (EEOC) has issued final rules clarifying how Title I of the Americans with Disabilities Act (ADA) and Title II of the Genetic Information Nondiscrimination Act (GINA) apply to employer wellness programs. The final rules remain fairly consistent with the 2015 proposed rules however they provide much needed clarification and additional guidance necessary to ensure employers structure their wellness programs without violating the ADA or GINA. Final Wellness Program Requirements under ADA and GINA Must be Voluntary – If an employer’s wellness program includes disability-related inquiries or a medical examination, the program must be voluntary. To…

2nd Quarter Newsletter 2016

Below please find our Compliance Observer Newsletter for the second quarter of 2016. This newsletter contains information on many employee benefits compliance issues. The following articles, information, and important reminders are contained in this Newsletter: ACA Reporting Extensions & Penalty Relief Departments Finalize SBC Templates HHS Releases Annual Out-of-Pocket Limits for 2017 Phase 2 of HIPAA Audit Program Marketplace Notices & Subsidy Appeals Moratorium on Health Insurance Providers Fee Agencies Provide Guidance on Preventive Services, Rescissions, Mental Health Parity, and More New FMLA Poster and Employer’s Guide ACA in the Courts – A Case to Watch Affordability Contribution Increased for 2017 CMS Data Match…

HIPAA Compliance Reviews – Audit Protocol

The Department of Health and Human Services (HHS) has launched the second phase of its HIPAA audit program, which focuses on compliance with HIPAA’s Privacy, Security and Breach Notification Rules. HHS’ Office for Civil Rights (OCR) is responsible for conducting these audits. This second phase of the HIPAA audit program covers both covered entities and business associates. According to OCR, these HIPAA audits are primarily a compliance improvement activity. However, if an audit reveals a serious compliance issue, OCR may initiate a compliance review to investigate. In connection with this second phase of HIPAA audits, OCR released an updated audit…