Employee Benefits Resources

Insights focused on supporting HR leaders

Table of 2025 Indexed Benefit Limits

We are providing a table below of 2025 indexed benefit limits we have seen published so far. We updated each … Read More >

Final §1557 Nondiscrimination Rules

On May 6, 2024, the Department of Health & Human Services (HHS) published final rules that expand several of the … Read More >

2025 Indexing for HSAs and EBHRAs

On Thursday, May 9, 2024, the IRS released 2025 indexing for health savings accounts (HSAs) and excepted benefit health reimbursement arrangements … Read More >

Understanding Benefits & Tax Implications for Company Owners

DOWNLOAD THE PDF Author: Michelle Cammayo | Compliance National Practice Lead Companies are generally permitted to offer employer-sponsored group benefits … Read More >

HIPAA Breach Notifications: Group Health Plans

There has been a prevalence of cyberattacks and data breaches on health plan related companies recently, and we expect more … Read More >

Final Rule Rescinds 2018 Association Health Plan (AHP) Rules

Back in 2018, agency rules established looser criteria under ERISA for determining when unrelated employers may join or create a … Read More >

Health Care Costs and Your Employee Health Plan

Author: Adam Moret / Whole Health Practice Lead  Health care costs, and consequently employee health benefits costs, have been increasing … Read More >

Paid Leave Oregon (PLO) –
Re-Approval Process & Next Steps

Background Employers are permitted to implement an equivalent plan in lieu of the state administered PLO benefits. An equivalent plan … Read More >

How Employers Can Help Employees Prepare for Retirement

DOWNLOAD THE PDF Retirement is a significant milestone for all employees that often requires careful planning. Unfortunately, many employees have … Read More >

HIPAA Privacy Rule for Reproductive Health Care

Deemed necessary following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, HHS has issued a new … Read More >

Medicare Part D Changes: Impact to group health plans

Background  Employers sponsoring a group health plan that provides prescription drug coverage are required to determine whether the prescription drug … Read More >

Senate Bill 1515 – New Oregon Law Aligns Oregon Family Leave Act (OFLA) and Paid Leave Oregon (PLO)

Author: Michele McCall | Compliance Manager, Employee Benefits The Oregon Legislature passed Senate Bill 1515 and it was signed by … Read More >

Clear Message, Engaged Employees

DOWNLOAD THE PDF Author: Erin Gallion | Employee Experience National Practice Leader Effective communication is crucial to fostering a positive … Read More >

Considerations for Evaluating a Pharmacy Benefits Manager (PBM)

DOWNLOAD THE PDF Author: Austin Nabor | Director of Pharmacy, Employee Benefits A pharmacy benefits manager (PBM) is an entity … Read More >

2024-01-29 DOL Updates Civil Monetary Penalties for 2024

The Department of Labor has announced updated penalty amounts for violations assessed a penalty after January 15, 2024.  Below is a table … Read More >

Final Rule on STLDI and Indemnity Plans

The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS), [collectively, “the … Read More >

San Francisco Health Care Security Ordinance (HCSO) Annual Reporting Due 5/3/24

The deadline to complete the San Francisco Health Care Security Ordinance Annual Reporting for 2023 is May 3, 2024. Employers … Read More >

Johnson & Johnson (J&J) Facing Class Action Lawsuit for Mismanaging Rx Program

J&J is being sued and facing a class action lawsuit where the plaintiff alleges breaches of fiduciary duty and violations … Read More >

What We’re Watching: AI for HR

DOWNLOAD THE PDF Author: Annette Kreuz | Vice President, Employee Benefits The age of artificial intelligence (AI) is now and … Read More >

Investing in Growth: The Strategic Value of Fertility Benefits for Your Team

DOWNLOAD THE PDF Authors: Adam Moret | Whole Health Practice Lead Emma Schroder | Benefits Wellness Coordinator Fertility is a … Read More >

Children’s Health Insurance Program (CHIP) Notice: Updated

Federal regulations require employers to distribute the CHIP notice annually to eligible employees who live in a state offering premium … Read More >

ChatGPT’s Top 5 Trends Impacting Employee Benefits: Work-Life Balance (Part 4 of 5)

DOWNLOAD THE PDF Author: Jessi Ryan | Vice President, Business Consulting | jessi.ryan@imacorp.com   In this study, we tasked ChatGPT … Read More >

Prescription Drug Data Collection (RxDC) Reporting: Round 3

As part of the Consolidated Appropriations Act, 2021 (CAA), all insurance companies and self-funded health plans (except HRAs, ICHRAs and … Read More >

Prioritizing Mental Health Part 2: The Link Between Mental Health and Employers’ Healthcare Expenses

DOWNLOAD THE PDF By: Annette Kreuz | Vice President, Employee Benefits Evan Oslica | Client Advisor When discussing mental health, … Read More >

2024 Reminder to Report Medicare Part D Creditability to CMS

All employers sponsoring a medical/Rx plan are responsible for completing an online form with the Centers for Medicare and Medicaid Services (CMS) if … Read More >

FPL Index for 2024

Many applicable large employers (ALEs) utilize the federal poverty line (FPL) affordability safe harbor to avoid penalties under the Affordable … Read More >

Affordable Care Act (ACA) Reporting: Common FAQs Including Which Employers Must Report

Following our article reminding employers of the ACA reporting deadlines, we thought it may be helpful to provide a list … Read More >

Gender Care Considerations

Coverage for gender identity treatment and services is an evolving issue.  Group health plans that exclude or limit coverage for … Read More >

Health Insurance Marketplace Coverage Model Notice: Updated

Federal regulations require employers to distribute the marketplace exchange notice to all new hires, regardless of their benefits eligibility. The … Read More >

Refresher on CAA and Transparency Provisions to Date

Employers as plan sponsors have several Consolidated Appropriations Act (CAA) and other health plan transparency provisions to ensure are being handled on … Read More >

Using Data Analytics to Drive Success in Employee Benefits: Part 2

DOWNLOAD THE PDF Author: Scott Ogburn | Senior Vice President, Employee Benefits Jordan Paulus | Vice President, Director, Strategy and … Read More >

2024 Paid Leave Oregon (PLO) – Update to Taxable Wage Cap

The PLO contribution rate for 2024 will stay the same as 2023 at 1% of each employee’s wages.  However, employers … Read More >

New Oregon Consumer Protection Laws Effective January 1, 2024

2024 Oregon consumer protections laws included multiple mandates for fully insured group health plans sold in Oregon.  The Oregon Division … Read More >

CA AB 567 – CA Long Term Care (LTC) Update

The topic of a LTC in CA is again gaining traction with the latest, and last step, completed by the … Read More >

Foreign Language Counties List for SBCs Updated Nov 2023

Summaries of Benefits and Coverage (SBCs) and claims and appeals notices of non-grandfathered health plans are required to include foreign … Read More >

IRS Providing Way for Employers to Repay 80% of Questionable ERC Claims

On Thursday, December 21, 2023, the IRS announced a way for employers to voluntarily pay back 80% of questionable Employee … Read More >

Affordable Care Act (ACA) Reporting Deadline Reminders

This article serves as a reminder for ACA Reporting Deadlines imposed on Applicable Large Employers (ALEs). There are two components … Read More >

Using Data Analytics to Drive Success in Employee Benefits: Part 1

DOWNLOAD THE PDF Author: Scott Ogburn | Senior Vice President, Employee Benefits Jordan Paulus | Vice President, Director, Strategy and … Read More >

Broadening the Talent Pool: How Employers Can Connect with Underrepresented Ethnic and Social Groups

DOWNLOAD THE PDF Written by: Robert Mitchell | Producer In today's increasingly diversified and globalized world, fostering an inclusive work … Read More >

Year End Reminders for 2023

The majority of group health plans renew on January 1. With open enrollment (OE) behind us and a new plan … Read More >

ChatGPT’s Top 5 Trends Impacting Employee Benefits: Telemedicine (Part 3 of 5)

DOWNLOAD THE PDF Written by: Erin Gallion | Practice Lead, Communications & Engagement We asked ChatGPT to predict the next … Read More >

Managing the Growing Side Hustle Trend

DOWNLOAD THE PDF Author: Robert Mitchell | Producer Nowadays, it's not uncommon to find your team members running online shops, … Read More >

2025 Indexing of Out-of-Pocket Limits and Affordable Care Act Penalties

Regulators have announced proposed benefit and payment parameters for 2025 which mostly concern the operation of the individual insurance Marketplace.  … Read More >

How Reference-Based Pricing Can Help Bring Transparency and Affordability to Healthcare

DOWNLOAD PDF Written by: Robert Mitchell | Producer Reference-based pricing (RBP) is a pricing strategy gaining popularity in the healthcare … Read More >

BCBSA Class Action Lawsuit: Settlement Update

After an appeal effort, the 11th Circuit has upheld the $2.67 billion settlement in the massive class action lawsuit against … Read More >

CA Fully Insured Health Plans Must Cover OTC Contraception Starting in 2024

In September of 2022, Governor Newsom signed SB 523, the Contraceptive Equity Act of 2022, into law which, amongst other … Read More >

2024 Health FSA & Qualified Transportation Limits

In Revenue Procedure 2023-24, the IRS sets forth a variety of 2024 adjusted tax limits. Among other things, the notice … Read More >

Washington Paid Family & Medical Leave Premiums for 2024

The Washington Employment Security Department (WA ESD) has announced the 2024 premium rates for the Paid Family and Medical Leave … Read More >

Understanding and Overcoming Proximity Bias in Hybrid Workplaces

Download The PDF In the rapidly evolving employment landscape, where remote and hybrid workplaces have become increasingly prevalent, the concept … Read More >

Regulators Remove Enforcement Relief for Two Transparency Requirements

In FAQs Part 61, federal regulatory agencies announce they are removing enforcement relief for the following  two Transparency in Coverage … Read More >

IRS Allows Employers to Withdraw Faulty Employee Retention Credits (ERC)

On September 14, the IRS announced a moratorium for the rest of 2023 whereby employers may not submit Employee Retention … Read More >

PCOR Fee Indexed in IRS Notice 23-70

The Patient Centered Outcomes Research (PCOR) Institute created by the Affordable Care Act (ACA) was funded by a temporary fee … Read More >

IRS Publishes Final ACA Forms and Instructions for 2023

The IRS has published final forms and instructions for insurance companies and employers to use for calendar year 2023 Affordable … Read More >

Helping Employees Prepare for Student Loan Repayment at the End of This Month

The student loan repayment pause has given borrowers a break from paying for a few years, but starting this October, … Read More >

California Expands Paid Sick Leave starting January 1, 2024

The California (CA) legislature passed S.B. 616, which expanded the State’s existing paid sick leave mandate, the Healthy Workplaces, Healthy … Read More >

MLR Rebates: Understanding the Employer’s Role

Employers sponsoring a fully-insured group health plan may have received a check from their insurance company. This check is an … Read More >

Oregon Senate Bill 1529: Employer Health Plan Changes

Oregon Senate Bill (SB) 1529 recently passed by the state legislature brings new requirements for employer sponsored health plans.  Effective … Read More >

The Power of Hispanic Inclusion in the Workplace

DOWNLOAD THE PDF In 2022, there were roughly 64 million Hispanics living in the United States, making up 19% of … Read More >

Prioritizing Mental Health Part 1: Knowing Your Population

Download The PDF HR leaders often recognize mental health's impact on their employees and the company’s bottom line, but getting … Read More >

The Role of HR in Compliance

Download The PDF In today's ever-evolving business landscape, organizations face increasing rules and regulations that govern operations. Failure to comply … Read More >

Why Organizations Need a Global Benefits Strategy

Download The PDF Written by: Tanja Lumpp | Global Risk & Benefits, Managing Director In an increasingly interconnected world, more … Read More >

Early Preparation for 2024 Open Enrollment

Download The PDF The labor landscape was undoubtedly a roller coaster in the first half of 2023, and employers are … Read More >

ChatGPT’s Top 5 Trends Impacting Employee Benefits: Financial Health (Part 2 of 5)

Download the PDF We asked ChatGPT to predict the critical trends impacting employee benefits in the United States over the … Read More >

Medicare Part D Annual Notice Reminder

Each September, IMA provides a reminder for employers to distribute the annual Medicare Part D notice before October 15 to: All enrolled … Read More >

Mental Health Parity – Agency Guidance & Enforcement

On July 25, the Departments of Labor, Health and Human Services, and the Treasury issued several mental health parity-related documents, … Read More >

San Francisco’s Health Care Security Ordinance Requires New Contribution Rates for 2024

Employers in San Francisco should be aware of a rate change in the Employer Spending Requirement (ESR) effective January 1, … Read More >

2024 Affordability Percentage Decreases to 8.39%

In Revenue Procedure 2023-29, the IRS significantly decreased the affordability percentage from 9.12% to 8.39% for 2024. Background Under §4980H, … Read More >

Understanding Medical Trend and the Impact on Employer Health Plan Renewal Rates

Download The PDF Currently, healthcare costs in the United States are high and rising, outpacing inflation and wage increases. While … Read More >

Paid Leave Oregon (PLO): APPLICATION PROCESS BEGINS

Background: PLO covers paid family leave, medical leave, and safe leave.  More details on the program are discussed in our … Read More >

Navigating the New Normal of Talent Shortages

Download The PDF As talent shortages persist across industries, an increasing number of employers are grappling with the need to … Read More >

Workplace Flexibility Means More than WFH

In today's post-pandemic, work-from-home business landscape, workplace flexibility has emerged as a crucial factor in attracting and retaining top talent. … Read More >

Proposed Rule on Short-Term Limited Duration Insurance, Hospital & Fixed Indemnity Plans as Excepted Benefits and their Tax Treatment, and Level-Funded “Plans”

Introduction The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS), [collectively, … Read More >

Texas House Bill 711: Eliminating Anti-Steering and Anti-Tiering Practices in Health Care

In a significant move to improve healthcare access and affordability, Texas House Bill 711 (TX HB 711), recently passed by … Read More >

More on Federal Transparency Efforts: FAQs Part 60 Provide Clarity

Background: The Federal Government has made significant efforts in bringing transparency to the healthcare market via the CMS Transparency in … Read More >

Sunset of MHPAEA Opt-Out for Self-Funded Non-Federal Governmental Health Plans

Non-federal governmental employers with self-funded health plans have long been able to opt-out of several requirements, one of which has … Read More >

Tax Treatment of Certain Wellness Arrangements

The IRS recently released Memorandum Number 202323006 (“the Memo”[1]) which addresses the tax treatment of arrangements that claim to offer … Read More >

IRS Guidance Ends HSA Relief for COVID-19 Testing and Treatment

A high deductible health plan (HDHP) eligible to be coupled with a health savings account (HSA) requires meeting a federal … Read More >

Changes to California (CA) State Disability Insurance (SDI) Program: What Employers Should Know

Background CA currently has a statutory SDI program that is funded by payroll taxes. The statutory disability program has been … Read More >

ChatGPT’s Top 5 Trends Impacting Employee Benefits: Mental Health (Part 1 of 5)

Download The PDF We asked ChatGPT to identify five important trends that will impact employee benefits in the United States … Read More >

Understanding and Preventing Heat Stress:

Adhering to NIOSH Guidelines and OSHA Regulations Heat stress is a serious concern that can cause various health conditions, like … Read More >

Preventive Mandates Remain Intact During Fifth Circuit Review

Background On March 30, 2023, the Braidwood decision was issued by a US District Court in TX which effectively meant … Read More >

Washington (WA) Long Term Care (LTC) Tax to Begin July 1, 2023

WA passed a LTC payroll tax law back in 2019 which was originally set to begin at the start of … Read More >

How HR Leaders Can Help Entry-Level Employees Contribute to 401(k) Plans

Many companies offer a 401(k) plan as part of a benefits package to lure talent to their organization, but generating … Read More >

New TX Law Restricts Gender Affirming Care for Youth Effective September 1, 2023

Texas SB 14, which has been sent to the Governor to become law, will severely restrict gender affirming treatment on … Read More >

Best Practices for Exit Strategies

Written by: Michael Waldman | Executive Vice President, Employee Benefits   While exit interviews come at the heels of an … Read More >

Patient-Centered Outcomes Research Institute Fees Due By July 31, 2023

The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, clinicians, payers, and the public … Read More >

HSA Indexing for 2024

On Tuesday, May 16, 2023, the IRS released 2024 indexing for health savings accounts (HSAs) and excepted benefit health reimbursement arrangements (EBHRAs).  … Read More >

Covid-19: Certain Telemedicine Flexibilities Extended via Temporary Rule

The Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary rule to … Read More >

IRS Provides Another Reminder of FSA Claim Substantiation Requirements

On April 28, 2023, the IRS’s Office of Chief Counsel published a memorandum recounting the existing claim substantiation requirements for … Read More >

Getting Employees Back in the Office

After Elon Musk announced the return of in-person work at Twitter and Bob Iger said the same at Disney, CEOs … Read More >

Strategies for Improving Employee Relations

The relationship HR and management have with employees is fundamental to the success of any business. Leadership is often faced … Read More >

Boosting Employee Morale After Layoffs

In a time of looming recession, market inflation, and falling stock prices, mass layoffs at your organization could be on … Read More >

COVID-19 Public Health Emergency (PHE) is Expiring: Agency FAQs Released

In our previous alert, we outlined how the end of the PHE will affect group health plans. In other words, … Read More >

San Francisco Health Care Security Ordinance (HCSO) Annual Reporting Due 5/1/23

The deadline to complete the San Francisco Health Care Security Ordinance Annual Reporting for 2022 is May 1, 2023. Employers … Read More >

National Emergency and Outbreak Period Ending

In late January of this year, the White House announced that it intended to end the pandemic-related National Emergency and … Read More >

Court Rules on Legality of Some Preventive Care Mandates

On May 15, 2023, the US Court of Appeals for the Fifth Circuit issued a stay on the Braidwood ruling … Read More >

Ensuring Your Remote Workers Stay Cyber Secure

Our current work environment presents new cybersecurity challenges for businesses. With one-half to two-thirds of U.S. employees working remotely in … Read More >

Table of 2024 Indexed Benefit Limits

We are providing a table below of 2024 indexed benefit limits we have seen published so far. We updated each … Read More >

3 Failproof Recruitment Strategies for Attracting Top Talent

It’s a tough time for HR managers. During the pandemic, people left the coasts for the country and started working … Read More >

Federal National Medical Support Notice (NMSN) Updated

The federal government has updated the National Medical Support Notice (NMSN), instructions, and employer FAQs.  State agencies and courts use … Read More >

IRS FAQs Clarify When General Health Expenses are Qualified Medical Expenses

On Friday, March 17, 2023, the IRS announced they have assembled a series of frequently asked questions (FAQs) to clarify … Read More >

Nation’s Top 3 Insulin Manufacturers Promise Price Cuts

On March 1, Eli Lilly announced cuts to insulin list prices and providing an automatic cap on “out-of-pocket costs at … Read More >

IRS Indexes ALE Penalties for 2024

The IRS has announced indexed penalties for applicable large employers (ALEs) for 2024.  Below we provide the penalties for 2022, … Read More >

Leading a Multigenerational Workforce

We’ve all heard the phrases “young and hungry” or “older and wiser.” Each generation has defining characteristics and personality traits … Read More >

Proposed Rules for Contraceptive Services

The Affordable Care Act (ACA) requires non-grandfathered health plans to cover contraceptives in 18 FDA-defined categories with no cost sharing.  … Read More >

Air Ambulance Reporting – Latest Update

Background The No Surprises Act (NSA) includes a section requiring carriers and health plans to report information regarding air ambulance … Read More >

Gag Clause Attestation Guidance Released

The Internal Revenue Service (IRS), Department of Labor (DOL), and Department of Human Services (HHS) [collectively, “the Departments”] have released … Read More >

Removing Bias from Employee Evaluations

Humans make thousands of decisions every day. To handle that volume, our brains need ways to save time and energy. … Read More >

Inflation and the Impact on Wages

The cost of everyday essentials has increased. From gas to groceries, the cost of goods has gone up, and employees … Read More >

IRS to Require Small Employers to E-File

Background: The Affordable Care Act (ACA) requires Applicable Large Employers (ALEs) to file 1094-C/1095-C forms with the IRS and requires … Read More >

COVID-19 Public Health Emergency is Expiring: What Employers Should Know

The White House has announced that it intends to extend (briefly) the public health emergency (PHE) one more time and … Read More >

Reminder to Complete Part D Creditability Reporting to CMS

All employers sponsoring a medical/Rx plan are responsible for completing an online form with the Centers for Medicare and Medicaid … Read More >

Prescription Drug Data Collection (RxDC) Reporting: Fully Insured Group Health Plans Must Take Action

As part of the Consolidated Appropriations Act, 2021 (CAA), all insurance companies and self-funded health plans (except HRAs and ICHRAs) … Read More >

Best Practices for Performance Evaluations

Performance reviews are an essential managerial responsibility and crucial to a company’s success, but they can quickly become a futile … Read More >

Medicaid Redeterminations Will Start Again: What Employers Should Know

We recently wrote that the White House has announced that the public health emergency (PHE) will end on May 11th, … Read More >

How Offering Unlimited PTO Can Soften the Return to In-person Work

If your company operates in a predominately work-from-home model, asking employees to return to the office may elicit pushback from … Read More >

White House Announces Intent to End COVID Emergency Declarations

The White House has announced their intent to renew the COVID-19 public health emergency and national emergency one last time … Read More >

California (CA) SB 1162 Pay Scale Disclosure and Pay Data Reporting Updates

Background: The CA Equal Pay Act has been around for decades with the intent of prohibiting employers from paying its … Read More >

FPL Index for 2023

Many applicable large employers (ALEs) utilize the federal poverty line (FPL) affordability safe harbor to avoid penalties under the Affordable … Read More >

DOL Updates 2023 Penalty Amounts

The Department of Labor has announced updated penalty amounts for violations assessed a penalty after January 15, 2023.  Below is a … Read More >

How Organizations Can Better Support Working Parents

Supporting working parents is no small task for HR leaders. Building a supportive, inclusive workplace for moms and dads, then … Read More >

Strategies for Upskilling Your Workforce

Automation is changing the nature of work. New AI technology may render a certain role obsolete. Meanwhile, your company is … Read More >

No Surprises Act: Summary of Provisions

The No Surprises Act (NSA) was enacted as part of the 2021 Consolidated Appropriations Act and its major provisions went … Read More >

Promoting Workplace Health to Prevent Chronic Illnesses

The COVID-19 pandemic ultimately impacted individuals of all ages, genders, and health status, but it became clear early on that … Read More >

Lifting the Voice of Your Employees

Returning to the office is increasingly becoming more top of mind. Here, we discuss how to navigate these turbulent waters … Read More >

Telemedicine & HSA Relief Included in 2023 Consolidated Appropriations Act (CAA)

In an article earlier this month, we reminded employers of telehealth relief for HSA participants expiring at the end of … Read More >

New Guidance and Delayed Enforcement for Prescription Drug Data Collection (RxDC)

On the eve of the requirement for employer sponsored health plans and health insurance carriers to submit prescription drug cost … Read More >

Paid Leave Oregon – Model Notice Posting Deadline and Tax Guidance

The starting date for contributing to Oregon’s new paid leave program is quickly approaching and employers who have workers in … Read More >

Year End Reminders for 2022

Year End Reminders for 2022 The majority of group health plans renew on January 1. With open enrollment (OE) behind … Read More >

Affordable Care Act (ACA): IRS Finalizes Permanent Deadline Extensions for Certain Forms

  The IRS released final regulations permanently extending the deadline for employers to provide copies of the Form 1095 to … Read More >

More Healthcare Transparency Efforts – Price Comparison Tool Coming in 2023

Background: The past 12 months have been focused on due dates for promoting health plan cost transparency brought on by … Read More >

Why Employers Should Consider Offering a Student Loan Repayment Program

The “Great Resignation” and adoption of remote work are forcing HR leaders to look for any competitive edge in the … Read More >

Telehealth Relief Ending in 2023: Group Health Plans May Be Impacted

The Consolidated Appropriations Act (CAA), signed in March 2022, included relief that telemedicine coverage would be temporarily disregarded for purposes … Read More >

Addressing Inflation Worries During OE

With insurance premiums rising, the cost of company-sponsored benefits increases for employers and employees, leading to tough decisions. During the … Read More >

Remote Monitoring Software

Many employers have risen to the challenge of remote work by implementing radically new thinking, modern technology and experimentation. One … Read More >

Paid Leave Oregon – Employer Action Required for OR Workers

Employers who have workers in OR should be aware of two important deadlines approaching. Contributions to the state funded program … Read More >

PCOR Fee Indexed in IRS Notice 22-59

The Patient Centered Outcomes Research (PCOR) Institute created by the Affordable Care Act (ACA) was funded by a temporary fee … Read More >

New Preventive Care Requirement to Cover Anxiety Screening for Youth

Background: The United States Preventive Services Task Force (USPSTF) makes evidence-based recommendations about preventive services which are created for primary … Read More >

State Medicaid Programs Preparing for End of Public Health Emergency (PHE) – Employer Impact

The PHE was extended another 90 days on October 15th, but many believe the federal government will let the PHE … Read More >

IRS Employee Retention Credits (ERC) Gaining Attention for the Wrong Reasons

The IRS recently issued a warning bringing attention to third parties who are seemingly targeting employers who may be eligible … Read More >

IRS Indexes 2023 FSA, Commuter, HCE, Key, and Other Limits

In Revenue Procedure 2022-38 and Notice 2022-55, the IRS sets forth a variety of 2023 adjusted tax limits. While there … Read More >

Hearing Aids Now Available Over The Counter (OTC)

In 2017, Congress ordered the Food and Drug Administration (FDA) to develop rules that would allow and encourage OTC sales … Read More >

IRS Issues Final Rules for Family Coverage Affordability Determination

The IRS has issued final regulations that change the way employer-sponsored plan affordability is calculated when determining if a family … Read More >

CA Parent Healthcare Act – Effective 1/1/23 for CA Individual Health Plans

Last October, Gov. Newsom signed CA AB 570 into law which is set to go into effect on January 1, 2023. The … Read More >

Paid Leave Oregon (PLO) – Opt Out Equivalent Plan Applications Now Available

Equivalent plan applications for employers to opt out of Paid Leave Oregon (PLO) are now available.  As we discussed in … Read More >

Paid Leave Oregon (PLO) – New Resources For Employers

  The Oregon Employment Department continues to develop the Paid Leave Oregon program and the supporting website.  PLO is a … Read More >

Medicare Part D Annual Notice Reminder

Each September, IMA provides a reminder for employers to distribute the annual Medicare Part D notice before October 15 to: All enrolled … Read More >

No Surprises Act Guidance for Reference Based Plans

Reference Based Pricing Plan (RBP): A plan that reimburses a fixed amount for a given medical service using a formula … Read More >

San Francisco Health Care Accountability Ordinance (HCAO) – Updated

Background: The HCAO applies to most San Francisco city contractors and tenants (including those at the San Francisco international Airport … Read More >

New Contraception Coverage Guidance

Issue Date August 14, 2022  In response to the number of complaints the Departments of Labor, Health and Human Services … Read More >

Blue Cross Blue Shield Association (BCBSA) Class Action Lawsuit – UPDATE

On August 9, 2022, an Alabama federal court granted final approval to this settlement, which will pay $2.67 billion to … Read More >

Student Loan Debt Forgiveness and Remaining Student Loan Debts

The Biden administration announced broad student loan forgiveness of up to $10,000 per borrower (or up to $20,000 for Pell … Read More >

FAQ 55 Clarifies Employers Do Not Need to Post MRFs

On August 19, federal regulators released frequently asked questions (FAQs) part 55.  One of those Q&As clarifies the employer’s responsibility … Read More >

Inflation Reduction Act Becomes Law

On Tuesday, August 16, 2022, President Biden signed into law the Inflation Reduction Act (H.R. 5376).  The Act primarily focuses … Read More >

CDC August 2022 Updates to COVID-19 Guidelines

The Centers for Disease Control (CDC) updated federal guidelines on quarantines.  "This guidance acknowledges that the pandemic is not over, … Read More >

Court Rules Religious Employer Violated Title VII by Excluding Same-Sex Spouse from Health Plan Eligibility

Supreme Court decisions in recent years have declared same-sex marriage is legal in all states (Obergefell v. Hodges, 2015) and … Read More >

Next Up in Transparency – RxDC Reporting

Federal Transparency Efforts: Prescription Drug and Health Cost Reporting Is Next What is it? As part of the Consolidated Appropriations … Read More >

Colorado FAMLI Division Issues Guidance Regarding Private PFML Plans

Colorado’s new paid family and medical leave program (known as FAMLI) allows employers to satisfy their obligations by adopting a … Read More >

2023 Affordability Percentage Decreases to 9.12%

In Revenue Procedure 2022-34, the IRS significantly decreased the affordability percentage from 9.61% to 9.12% for 2023. Background Under §4980H, … Read More >

Paid Leave Oregon (PLO) – Oregon’s New Paid Family and Medical Leave Insurance Program

The final for the state’s paid family and medical Leave insurance program, known as Paid Leave Oregon, are expected to … Read More >

Initial Federal Responses to Dobbs Decision

We have seen surveys showing about half of employers will not be implementing immediate changes following the Dobbs decision, but … Read More >

Regulators Will Enforce Mandatory Contraceptive Coverage Rules in All States

On June 27, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury … Read More >

Court Rules that A County’s Health Plan Violated Title VII by Excluding Gender Transition

There has been health plan confusion relating to coverage of gender affirming care since the §1557 regulations in 2016, amendments … Read More >

Roe v Wade Group Health Plan Considerations

This past Friday, June 24, 2022, the Supreme Court of the United States (SCOTUS) issued a decision in Dobbs v. … Read More >

US Supreme Court Determines Health Plan Limited Dialysis Benefit Did Not Violate Medicare Secondary Payer Act

DaVita, one of the nation’s largest dialysis providers, sued Marietta Memorial Hospital over its limited dialysis coverage.  The plan offered … Read More >

US Supreme Court Overturns Roe v. Wade: Group Health Plan Comments

Early in the morning on Friday, June 24, 2022, the Supreme Court of the United States (SCOTUS) issued a decision … Read More >

CMS Technical Clarification – TIC Final Rule Machine Readable Files

With July 1 fast approaching it is still not entirely clear how, or even if, employers should link to their … Read More >

COVID-19 Vaccines Approved Down to 6 Months Old, Health Plans Must Immediately Cover

On Friday, June 17, 2022, the US FDA granted Emergency Use Authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines … Read More >

7/1/22 Deadline to Post Machine-Readable Files – What You Need to Know if You Sponsor a Group Health Plan

The Transparency in Coverage (TiC) rule is gaining more attention as the deadline to post a public link to certain … Read More >

US District Court Rules in Favor of Christian Employers Alliance in Restricting Gender Affirming Care

The US District Court for the District of North Dakota has ruled that employers with membership in the Christian Employers … Read More >

Table of 2023 Indexed Benefit Limits

We're starting to see some 2023 indexed benefit limits, so we're providing this table for your convenience. We'll update each … Read More >

Patient-Centered Outcomes Research Institute Fees Due By July 31, 2022

The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, clinicians, payers, and the public … Read More >

HSA Indexing for 2023

Today the IRS released 2023 indexing for health savings accounts (HSAs) and excepted benefit health reimbursement arrangements (EBHRAs).  The HSA … Read More >

IRS Issues Proposed Rules to Fix the Affordability “Family Glitch”

The IRS has issued proposed rules that would change the way employer-sponsored coverage would be treated when determining if a … Read More >

San Francisco Health Care Security Ordinance (HCSO) Annual Reporting Due 5/2/22

The deadline to complete the San Francisco Health Care Security Ordinance Annual Reporting for 2021 is May 2, 2022. Employers … Read More >

HHS Notice Regarding Gender Affirming Care

On Wednesday, March 2, 2022, the Secretary of Health and Human Services (HHS) announced a notice affirming rights and protections … Read More >

Congress Temporarily Reinstates Telemedicine/HSA Eligibility Relief

Introduction The recently signed Consolidated Appropriations Act, 2022 (Act) includes another twist on telemedicine (sometimes referred to as telehealth) coverage … Read More >

Preventive Care Service Updates for 2023 Plans

The Affordable Care Act (ACA) regulations set forth mandatory medical plan design changes starting in 2014 that extended to all … Read More >

HIPAA, MSP, and SBC Penalties Indexed as of March 17, 2022

These penalties were indexed in November 2021, but they’re being updated effective March 17, 2022, for violations occurring on/after November … Read More >

Court Retroactively Reinstates Independent Contractor Final Rule

In early 2021, the new Biden administration delayed and then formally withdrew the Trump administration’s final “Independent Contractor Rule” that … Read More >

Handling Benefits for Military Leaves

With the United States sending military to NATO countries in Europe and otherwise increasing preparedness for uncertain times ahead, you … Read More >

DOL to Hire 100 Investigators to Enforce Worker Protections

The Department of Labor (DOL) announced it’s hiring 100 investigators to join its Wage and Hour Division (WHD), with the … Read More >

Biden Administration Extends National Emergency for Another Year

Introduction On February 18, 2022, President Biden formally extended the COVID-19 National Emergency for up to another year. The National Emergency first … Read More >

Court Strikes Down Some No Surprises Act Regulatory Language on Arbitration

Back in October 2021, we discussed the No Surprises Act Part II interim final rule which gave details on the … Read More >

California Governor Newsom signed New COVID-19 Supplemental Paid Sick Leave (CA SPSL) Bill Into Law

Background: Newsom’s prior CA SPSL via Senate Bill 95 expired on September 30, 2021 and it applied to employers with 26 or more … Read More >

UPDATE – Additional Guidance released for Health Plan Coverage of Over-The-Counter COVID-19 Tests

The Department of Labor (DOL), Secretary of Health and Human Services (HHS), and Department of the Treasury (Treasury) [collectively, “the … Read More >

Reduced WAPAL Fund Fee

What is it? The Washington (WA) Partnership Access Lines (PAL) funding program (WAPAL Fund) collects a fee from health plans.  … Read More >

California (CA) Senate Bill 510 Requires Health Plans to Expand Coverage of COVID-19 Testing

This week has certainly been abuzz with news and activity related to COVID-19. In light of all the new changes, … Read More >

California Employer Reporting Deadline Reminder

On January 1, 2020, California (CA) enacted its own individual mandate similar to the repealed federal individual mandate that requires … Read More >

ACA Reporting Deadline Reminders

The new year started off with quite a bang as SCOTUS made their ruling regarding the vaccine or test mandate, … Read More >

Reminder to Complete Part D Creditability Reporting to CMS

All employers sponsoring a medical/Rx plan are responsible for completing an online form with the Centers for Medicare and Medicaid … Read More >

Washington Long Term Care (LTC) Services and Supports Act – payroll tax for WA workers delayed until July 2023

Background: Washington state passed the Long-Term Care Services and Supports act in 2019. This bill quickly became known as the “LTC … Read More >

OSHA Withdraws Temporary COVID-19 Vaccination and Testing ETS Directive

The Department of Labor’s Occupational Safety and Health Administration (“OSHA”) issued a notice in the Federal Register on a statement on the … Read More >

FPL Index for 2022

Many applicable large employers (ALEs) utilize the federal poverty line (FPL) affordability safe harbor to avoid penalties under the Affordable … Read More >

DOL Updates 2022 Penalty Amounts

The Department of Labor has announced updated penalty amounts for violations assessed a penalty after January 15, 2022.  Below is a table … Read More >

US Supreme Court Blocks OSHA’s ETS, Upholds CMS Vaccine Mandate on Health Care Facilities

On Thursday, January 13, 2021, the Supreme Court of the United States (SCOTUS) ruled on the two cases they heard … Read More >

Health Plans Must Cover OTC COVID Tests

On Monday, January 10, regulators issued FAQ Part 51 giving health plans just four days advance notice to implement mandatory … Read More >

Proposed 2023 OOP Limits and ALE Penalties

Federal regulators have announced publication of proposed 2023 rules for several Affordable Care Act (ACA) requirements, summarized in this fact sheet and … Read More >

PCOR Fee Indexed in IRS Notice 22-04

The Patient Centered Outcomes Research (PCOR) Institute created by the Affordable Care Act (ACA) was funded by a temporary fee … Read More >

Washington Cares Fund Premium Assessment Delay Announced

The recent statements released from Governor Inslee, House and Senate Democratic Leadership while attempting to provide relief to employers and … Read More >

EEOC Adds New Section to FAQ Guidance When COVID-19 May Be a Disability for Employment Purposes

On July 26, 2021, the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) issued Guidance on … Read More >

New York City (NYC) Mayor Announces First In-Nation Vaccination Mandate for Certain Workers

On December 6, 2021, the NYC mayor announced a private-sector worker vaccine mandate which takes effect on December 27th, 2021. … Read More >

Vaccine Mandate Court Updates as of December 18, 2021

Health Care Sector We have previously mentioned that the vaccine mandate on workers at most health care facilities accepting Medicare/Medicaid … Read More >

FDA Authorizes Pfizer Boosters for Teens Ages 16 and 17

On Thursday, December 9, 2021, the US Food & Drug Administration (FDA) authorized the use of the Pfizer-BioNTech COVID-19 booster … Read More >

President Biden Announces COVID-19 Winter Action Plan

On Thursday, December 2, 2021, the White House announced President Biden’s plans to combat COVID-19 this winter.  The action plan … Read More >

Vaccine Mandate Activity in November 2021

Following President Biden's executive orders announced in September, litigation and state legislation has picked up nationwide to resist the vaccine … Read More >

IRS Proposes Some Permanent Changes to ACA Reporting

On November 24, 2021, the IRS published a notice of proposed rulemaking with requests for public comments.  The proposals are … Read More >

Interim Final Rule on Mandatory Rx and Health Cost Reporting

On November 17, 2021, federal regulators announced an interim final rule with request for comments (IFC) detailing the CAA's Title … Read More >

Prescription Drug Importation Progress in 2021

In an effort to reduce prescription drug pricing, there has been activity in Washington, D.C. and elsewhere (such as in … Read More >

Table of 2022 Indexed Benefit Limits

With the IRS taking much longer than usual to publish FSA limits and ACA affordability percentages, we are finally able … Read More >

IL Publishes Guidance for Consumer Coverage Disclosure Act

On August 27, 2021, the Consumer Coverage Disclosure Act (“CCDA”) was signed into Illinois law. While the CCDA went into … Read More >

HIPAA, MSP, and SBC Penalties Indexed as of November 15, 2021

Federal regulators have announced inflationary adjustments to civil monetary penalties for violations occurring on/after November 2, 2015. Assessments on/after Jan … Read More >

Year End Reminders for 2021

With open enrollment behind us and the vaccine mandates and new plan year in our sights, it's time to wrap … Read More >

New Compensation Disclosure Requirements for Group Health Plan Service Providers

The Consolidated Appropriations Act (CAA), signed into law December 27, 2020, contained a provision that will soon require covered service … Read More >

Infrastructure Bill Terminates the Employee Retention Credit Early

As we've discussed previously several times over the last 18 months, some employers with full or partial government restrictions on … Read More >

IRS Indexes 2022 FSA and Commuter Plan Limits

In Revenue Procedure 2021-45, the IRS sets forth a variety of 2022 adjusted tax limits. Among other things, the notice … Read More >

Fifth Circuit Court of Appeals Temporarily Halts OSHA ETS

What's Happened with OSHA's ETS in Court Numerous lawsuits have been filed across the country, including 27 state attorneys general, … Read More >

CMS Issues Vaccine Mandate Rule for Health Care Providers

On September 9, 2021, President Biden issued a 6-step COVID Action Plan, and one step directed the Centers for Medicare … Read More >

OSHA Publishes Vaccine-or-Testing ETS for Employers 100+

On September 9, 2021, President Biden had issued a 6-step COVID Action Plan.  One step ordered the Department of Labor's … Read More >

Pfizer Vaccine Authorized for Children Age 5 and Up

On Friday, October 29, 2021, the US Food & Drug Administration (FDA) granted emergency use authorization (EUA) of the Pfizer/BioNTech … Read More >

Federal Contractor FAQs Updated to Provide Some Flexibility and Clarity

We've previously discussed the President's September 2021 executive order which would remove weekly testing as an option for federal contractors/subcontractors … Read More >

Self-Insured Employers May Need to Pay State of Washington “WAPAL Fund” Fee

The state of Washington has passed legislation that requires group health plans to pay a quarterly assessment to support a … Read More >

ICHRA Affordability Lookup Table Published

The Centers for Medicare and Medicaid Services (CMS) has published Marketplace premium lookup tables (along with a guide) for employers … Read More >

All Vaccines Authorized for Boosters, and Booster Allowed to be Different Brand

Pfizer's vaccine had been authorized for boosters for millions of Amerians back on September 24, 2021.  Now, about a month … Read More >

EEOC Updates Vaccine FAQs October 13 and 25, 2021

The Equal Employment Opportunity Commission (EEOC) has been maintaining a long list of frequently asked questions (FAQs) to help employers … Read More >

IRS Clarifies COBRA Premium Due Dates Under Outbreak Period Relief

On Wednesday, October 6, 2021, the IRS published Notice 2021-58 providing clarity around the Outbreak Period extensions in relation to … Read More >

Regulators Clarify Vaccine Misconceptions at Work

Federal regulators have issued clarifications on how certain federal laws apply in the context of COVID vaccines and protections at … Read More >

No Surprises Act – Part II Interim Final Rule

The No Surprises Act, passed as part of the Consolidated Appropriations Act, 2021 (CAA), includes prohibitions on certain "surprise" balance … Read More >

Draft 2021 Forms and Instructions for Early 2022 ACA Reporting

The IRS has finally published draft forms and instructions for 2021 ACA reporting due early 2022.  Not much has changed, … Read More >

Pfizer Booster Shots Authorized for Millions of Americans

On Wednesday, September 22, 2021, the US Food & Drug Administration (FDA) formally recommended Pfizer boosters six months following receipt … Read More >

IRS Guidance on How to Report 2021 FFCRA Leave

Some employers voluntarily extended into 2021 emergency COVID leave as outlined in the Families First Coronavirus Response Act (FFCRA), and … Read More >

Federal Contractor Vaccine Mandate FAQs

A set of FAQs has been published to help federal executive branch employees as well as federal contractors and subcontracors … Read More >

Reminder to Send Medicare Part D Notices before October 15

The Centers for Medicare and Medicaid Services (CMS) requires employers to annually notify plan participants whether the prescription drug coverage … Read More >

Biden’s Fall 2021 COVID Plan Affects Private Employers

On Thursday, September 9, 2021, President Biden issued a plan with a series of steps aimed at getting more Americans … Read More >

ACA Affordability Decreases to 9.61 Percent for 2022

The IRS has finally announced the affordability percentage for 2022, which is decreasing from 9.83% this year to 9.61% next … Read More >

Health Plan Premium Incentives and Surcharges Based on Vaccination Status

Last week, the FDA granted full approval to the Pfizer-BioNTech COVID-19 vaccine, which will now be marketed as Comirnaty, for … Read More >

Prediabetes Screening Recommendation Adjusted from Age 40 to 35

The US Preventive Services Task Force (USPSTF) regularly reviews and updates a list of recommendations for preventive care which should … Read More >

Regulators Delay Certain Group Health Plan Transparency Deadlines

Federal regulators had indicated in their Part 1 No Surprises Act guidance in July that they anticipated delaying enforcement of … Read More >

Reminder to Send ARPA COBRA Subsidy Expiration Notices

Believe it or not, it's almost time for COBRA subsidies provided under the American Rescue Plan Act (ARPA) to end.  … Read More >

United Health Group $15.6 Million Settlement on Alleged Mental Health Parity Violations

The Department of Labor's Employee Benefits Security Administration (EBSA) enforces the Mental Health Parity and Addiction Equity Act (MHPAEA) with … Read More >

Pfizer and Moderna EUA Expanded to Include Third Booster Shot for Immunocompromised, Most Plans Must Cover at No Cost Within 15 Days

The US Food and Drug Administration (FDA) announced late Thursday, August 12, 2021, that the Pfizer and Moderna mRNA vaccines … Read More >

Senate Passes Bipartisan $1.2 Trillion Infrastructure Deal and Agrees to $3.5 Trillion Budget Reconciliation

With 19 Republicans joining all Democrats, the Senate has passed the bipartisan $1.2 trillion Infrastructure Investment and Jobs Act by … Read More >

IRS Guidance on ERC for Last Half of 2021

The IRS announced it has issued Notice 2021-49 to clarify the rules of the employee retention credit (ERC) as extended … Read More >

DOL Investigating Legality of Vaccine Mandates, WA and Denver Mandate Vaccines on Certain Private Employers

While courts have thus far backed a hospital and a university having vaccine mandates (with legally required accommodations that don't … Read More >

WA Cares, A Washington State Public LTCi Program and Payroll Tax

The State of Washington passed the Long-Term Services and Supports (LTSS) Trust Act to establish a mandatory public long-term care … Read More >

IRS Adds New Covered Reason for Voluntary FFCRA Paid Leave

The IRS has announced an update to its FAQs for employers voluntarily extending FFCRA emergency paid leave provisions from April … Read More >

CDC Advising Caution with Delta Spread

With the delta variant of the virus being far more contagious, comprising over 80% of new infections, and daily case … Read More >

Long Covid May Qualify for Disability Protections

On Monday, July 26, 2021, the Department of Justice (DOJ) and Health and Human Services (HHS) commemorated the 31st anniversary … Read More >

IRS Provides Additional COBRA Subsidy FAQs

IRS Notice 2021-46 provides 11 additional FAQs about COBRA subsidies under the American Rescue Plan Act (ARPA).  The guidance clarifies: … Read More >

ACA FAQs Part 47 Address PrEP Preventive Care Mandate

Non-grandfathered plans are required under the Affordable Care Act (ACA) to cover certain in-network preventive care services and medications at … Read More >

CMS Proposes to Drastically Increase Price Transparency Penalties to Hospitals

Hospitals have been required since January 1, 2021, to publicly post their privately negotiated prices for 300 shoppable services so … Read More >

No Surprises Act – Part 1 Interim Final Rule

The Consolidated Appropriations Act of 2021 (CAA), passed in late December 2020, included measures to mitigate surprise balance billing (this … Read More >

Reminder for Calendar Year Plans to File Form 5500 (or an Extension) By End of July

Group benefit plans subject to ERISA generally must file a Form 5500 with the Department of Labor (DOL) by the … Read More >

Colorado Passes Law Creating State-Regulated Health Plan Option

On June 16, 2021, Colorado Governor Jared Polis signed into law House Bill 21-1232, also known as the “Colorado Standardized … Read More >

Supreme Court Rejects Challenge to the ACA

In a 7-2 ruling on Thursday, June 17, 2021, the Supreme Court of the United States (SCOTUS) rejected the Texas … Read More >

Federal Court Dismisses Lawsuit Challenging Hospital’s Mandatory Vaccination Policy

On June 12, 2021, a federal judge in Texas dismissed a lawsuit challenging a hospital’s mandatory COVID-19 vaccination policy for … Read More >

IRS Guidance on Expanded EPSL and EFML Tax Credits

The American Rescue Plan Act (ARPA) extended the FFCRA's EPSL/EFML tax credits for employers who voluntarily provide paid leaves for … Read More >

EEOC Updates Employer Vaccine Guidance

On Friday, May 28, 2021, the Equal Employment Opportunity Commission (EEOC) updated guidance for employers around COVID-19 vaccines.  This builds … Read More >

Reminder – PCOR Fee Due July 2021

Each July, employers that had a self-funded medical plan or a health reimbursement arrangement (HRA) with a plan year ending … Read More >

IRS Publishes 86 FAQs on ARPA COBRA Subsidies

Employers have been waiting for more detailed guidance on the COBRA subsidies that took effect April 1, 2021.  With notices … Read More >

State and Local Coronavirus Leaves

In response to the coronavirus (COVID-19) pandemic, states have passed new laws and issued new regulations and guidance about employee … Read More >

Pfizer/BioNTech Vaccine Authorized for Ages 12-15

On Monday, May 10, 2021, the Food & Drug Administration (FDA) announced they are amending the emergency use authorization (EUA) … Read More >

All Three Local Paid Leave Laws In Texas Struck Down

Following the Texas Supreme Court’s refusal on June 5, 2020, to review a temporary injunction against a paid sick leave … Read More >

Office of Civil Rights Now Including Gender Identity and Sexual Orientation in Anti-Discrimination Enforcement

On May 10, 2021, the Department of Health and Human Services (HHS) announced that effective immediately, the Office for Civil … Read More >

IRS Relief on Employment Tax Deposits Reduced for CAA and ARPA Credits

In IRS Notice 2021-24, the Treasury Department and IRS have announced relief for employers that reduce their payroll tax deposits … Read More >

IRS Relaxes Taxation of Daycare FSA Enhancements

The American Rescue Plan Act increased the calendar year 2021 income exclusion limit for daycare FSA reimbursements from the usual … Read More >

HSA Indexing for 2022

Today the IRS released 2022 indexing for health savings accounts (HSAs) and excepted benefit health reimbursement arrangements (EBHRAs).  The HSA … Read More >

BCBS Antitrust Settlement

In October 2020, the Blue Cross Blue Shield Association (BCBSA) and the BCBS companies reached a $2.67 billion settlement to … Read More >

HHS Final Benefit and Payment Parameters for 2022

Federal regulators have announced publication of final 2022 indexing for several Affordable Care Act (ACA) requirements, summarized in this fact … Read More >

Independent Contractor Final Rule Withdrawn

On May 5, 2021, the U.S. Department of Labor (DOL) announced it will officially withdraw the Independent Contractor final rule. … Read More >

Biden Calls on All Employers to Pay Time Off for the COVID-19 Vaccine

The President announced he "is calling on every employer in America to offer full pay to their employees for any … Read More >

Mental Health Parity FAQs Part 45

Federal regulators have published FAQs Part 45 addressing requirements under the Mental Health Parity and Addiction Equity Act (MHPAEA) in … Read More >

DOL Publishes COBRA Subsidy Notices and Limited FAQs

On Wednesday, April 7, 2021, the Department of Labor's Employee Benefits Security Administration (EBSA) published a dedicated American Rescue Plan … Read More >

CDC Updates Travel Guidelines for Fully Vaccinated Individuals

On Friday, April 2, the Centers for Disease Control and Prevention (CDC) updated guidance for fully vaccinated individuals to indicate … Read More >

IRS Extends Tax Filing and HSA Contribution Deadline

With the usual April 15 tax filing deadline near, the IRS has announced via Notice 2021-21 that the Form 1040 … Read More >

PPP Extension Act of 2021

On March 30, 2021, the President signed into law H.R.1799, the PPP Extension Act of 2021, to extend the PPP … Read More >

IRS Allows PPE to be Reimbursable Medical Expenses

In some rather odd timing, the IRS has just announced that purchases of personal protective equipment (PPE) can be treated … Read More >

Exchange Open Enrollment Extended Through August 15, 2021

The federal public Exchange Marketplace healthcare.gov had already opened a 3-month special enrollment period from February 15, 2021, through May … Read More >

CDC Guidance on Vaccinated Individuals and Vaccination Programs for Workers

A major part of the American Rescue Plan Act of 2021 (ARPA) is providing expedited access to vaccines and encouraging … Read More >

American Rescue Plan Increases 2021 Dependent Care Allowance to $10,500

One very short provision of the American Rescue Plan Act of 2021 (ARPA) allows up to $10,500 of dependent daycare … Read More >

Employee Retention Credit Extended for All of 2021

The Employee Retention Credit (ERC) has been utilized since the CARES Act as a way to help employers with partially … Read More >

Voluntary FFCRA Leave Extended Again, with Tweaks

The American Rescue Plan Act of 2021 (ARPA) includes a section which allows employers to voluntarily extend the emergency paid … Read More >

COBRA Subsidies under the American Rescue Plan

The American Rescue Plan Act of 2021 (ARPA) passed by Congress on Wednesday, March 10, 2021, includes a new 100% … Read More >

American Rescue Plan Passes, Signed into Law

The US House of Representatives had passed President Biden's American Rescue Plan Act of 2021 (ARPA, H.R. 1319) on Saturday, … Read More >

IRS Notice 2021-20 Clarifies Retroactive Employee Retention Credit Changes for 2020

On Monday, March 1, 2021, the IRS announced publication of IRS Notice 2021-20 to clarify retroactive rules governing the Employee … Read More >

FDA Grants EUA Approval for Single-Dose J&J Vaccine

On Saturday, February 27, 2021, the U.S. Food & Drug Administration (FDA) announced they have granted emergency use authorization (EUA) … Read More >

Outbreak Period Extension Guidance at the 1-Year Mark

The Department of Labor's Employee Benefits Security Administration (EBSA) has issued Disaster Relief Notice 2021-01 to clarify how "outbreak period" … Read More >

FAQ 44 Clarifies Health Plan Coverage of COVID-19 Tests

Section 6001 of the Families First Coronavirus Response Act (FFCRA) had stipulated that COVID-19 testing and services must be covered … Read More >

Are Outbreak Period Extensions Over?

Update Friday, February 26, 2021: We now have guidance via EBSA Disaster Relief Notice 2021-01 that Outbreak Period extensions will … Read More >

IRS Clarifies FSA Options and Offers Additional Flexibilities

The Taxpayer Certainty and Disaster Tax Relief Act of 2020, recently enacted as Division EE of the Consolidated Appropriations Act, … Read More >

CDC Updated Guidance on Quarantines, Schools, and Masks

On February 10, 2021, the Centers for Disease Control and Prevention (CDC) updated its quarantine recommendations so that "fully vaccinated … Read More >

Reminder to Report Part D Creditability to CMS by March 1

Reminder to Report Part D Creditability to CMS by March 1 Each year, the Centers for Medicare and Medicaid Services … Read More >

HHS Tells States To Expect All of 2021 To Remain a Public Health Emergency

With the need for States to plan with some predictability and stability, the Department of Health and Human Services has … Read More >

Johnson & Johnson Requests Single-Dose Vaccine EUA

Janssen Biotech of Johnson & Johnson has submitted a request for emergency use authorization (EUA) from the US Food and … Read More >

CO Soliciting Bids for Canadian Drug Importation Program

On Monday, January 25, 2021, the Colorado Department of Health Care Policy & Financing invited vendors to bid on several … Read More >

Early 2021 Covid Stimulus Proposals

We've previously discussed the President's $1.9 trillion proposal for the next round of relief, and Congress is prepared to forge … Read More >

IRS Updates FAQs for EPSL and EFML Tax Credits

The IRS has announced updates to the overview and FAQs for the FFCRA emergency paid leave tax credits.  The updates … Read More >

MHPAEA Comparative Analysis of NQTLs

A new requirement health plans face under the Consolidated Appropriations Act, 2021, is to provide comparative analyses to federal or … Read More >

Many More Executive Actions for January 2021

In addition to the 20 or so actions we previously mentioned from the President's first day in office, Biden has … Read More >

DOL Updates 2021 Penalty Amounts

The Department of Labor has announced updated penalty amounts for violations assessed a penalty after January 15, 2021.  Below is … Read More >

FPL Index for 2021

Many applicable large employers (ALEs) utilize the federal poverty line (FPL) affordability safe harbor to avoid penalties under the Affordable … Read More >

Biden’s Executive Actions First Day as President

As is typical for incoming presidents, Biden signed several executive orders and actions his first hours in office.  Some of … Read More >

Biden’s American Rescue Plan

President Biden has proposed an outline of his requests for the next coronavirus relief bill with an estimated $1.9 trillion … Read More >

FAQs Regarding Colorado’s Public Health Emergency Leave Requirements

The Colorado Department of Labor and Employment (CDLE) recently issued new regulations on December 23, 2020, just one holiday week … Read More >

HHS Extends Public Health Emergency to April 21, 2021

The US Department of Health and Human Services (HHS) has once again extended the declaration of a public health emergency … Read More >

Paid FMLA Tax Credit Extended 5 More Years

We've had a paid FMLA tax credit for the last three years, and the large coronavirus law passed over Christmas … Read More >

Final Rule on Affordable Insulin and Injectable Epinephrine

Last summer, the President issued an Executive Order on Access to Affordable Life-saving Medications.  This order directed Health and Human … Read More >

Revised Vaccine Distribution Plans

With the FDA stipulating COVID-19 vaccines are emergency use authorized only with the proper two-dose administration a few weeks apart, … Read More >

EEOC Proposes New Wellness Rules

The Equal Employment Opportunity Commission (EEOC) issued rules in 2016 governing how wellness plans can be structured to comply with … Read More >

Employee Retention Credit Changes and Extension to June 30, 2021

ERC Can Help Toward Paying Wages and Benefits As discussed in our December 22 alert on the new Coronavirus Response … Read More >

IRS Guidance – PPP Forgiven Expenses Can Be Deductible

Under the CARES Act, business expenses funded by a Paycheck Protection Program (PPP) loan and then forgiven would not be … Read More >

DOL Final Rule Clarifies Independent Contractor Status

Update May 5, 2021: Upon taking office, President Biden had delayed the effective date of this rule, and the DOL … Read More >

Democrats Win Both Georgia Senate Seats and Control of the US Senate

Get Ready for Reconciliation Democrats have flipped both Georgia Senate seats from the Republicans, resulting in the US Senate being … Read More >

Temporary Options for Health and Dependent Care FSAs

In our previous alert announcing the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSAA), we discussed the new flexible … Read More >

FFCRA Emergency Paid Leave Tax Credits Can Be Available Through March 31, 2021

Employers with fewer than 500 employees were subject to the FFCRA emergency paid leave provisions from April 1, 2020, through … Read More >

Colorado Adopts Emergency Rules Requiring All Employers to Provide Public Health Emergency Leave as of January 1, 2021

Colorado Adopts Emergency Rules Requiring All Employers to Provide Public Health Emergency Leave as of January 1, 2021 On December … Read More >

Consolidated Appropriations Act of 2021

The Coronavirus Response and Relief Supplemental Appropriations Act (CRRSAA) Is Signed into Law 12/27/20 Update: The President has signed the … Read More >

EEOC Issues New Guidance on COVID-19 Vaccines

EEOC Issues New Guidance on COVID-19 Vaccines On December 16, 2020, the EEOC updated its guidance on the COVID-19 pandemic … Read More >

Form 5500 Updated with Schedules and Instructions

On December 2, 2020, the Department of Labor's Employee Benefits Security Administration (EBSA), along with the IRS and the Pension … Read More >

CAL/OSHA Emergency Standards for COVID-19

On November 30, 2020, California approved new emergency standards on COVID-19 infection protection.  These standards apply to most workers in … Read More >

SCOTUS Upholds Arkansas Law Regulating PBMs

SCOTUS Upholds Arkansas Law Regulating PBMs On December 10, 2020, the United States Supreme Court issued a unanimous decision in … Read More >

Bipartisan, Bicameral Surprise Billing Proposal

Fresh on the heels of a final transparency rule, a bipartisan, bicameral committee of the chairmen and ranking members from … Read More >

Final Rules for Commuter and Parking Plans

The Tax Cuts and Jobs Act (TCJA) made several fringe benefit tax changes, such as repealing the deduction for qualified … Read More >

COVID-19 Vaccine FAQs

  As most employers are surely aware, the first COVID-19 vaccines are here and more are on the way. To … Read More >

Final Rule Gives More Flexibility For Grandfathered Health Plans

Federal regulators have finalized two changes they had proposed on July 15, 2020, that would give employers more flexibility to … Read More >

Year-End Reminders

With 2020 coming to a close, we thought it would be helpful to provide a few reminders for employers on … Read More >

Biden’s Health Leaders

Early Monday, President-elect Joe Biden announced several nominations to lead his health team. California Attorney General Xavier Becerra is nominated … Read More >

MA Annual HIRD Reporting Due December 15

Each year, employers with six or more employees in MA any of the last 12 months must provide a Health … Read More >

New ICD-10 Codes and MS-DRGs for Covid-19 in 2021

Coming January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) will introduce 21 new ICD-10 procedure codes for … Read More >

CDC Shortens Quarantines

The Centers for Disease Control and Prevention (CDC) are reducing the recommended quarantine for exposure to Covid-19 from 14 days … Read More >

FDA Covid-19 Activity the Week of November 30, 2020

The second Covid-19 vaccine candidate has been submitted to the US Food and Drug Administration (FDA) to request emergency use … Read More >

2022 Proposed OOP Limits and ALE Penalties

Proposed Benefit & Payment Parameters for 2022 The Affordable Care Act requires annual updates for numerous requirements for insurers and … Read More >

PCOR Fee Indexed

PCOR Fee Indexed for 2021 The Patient Centered Outcomes Research (PCOR) Fee was created by the Affordable Care Act (ACA) … Read More >

IRS Updates FFCRA Tax Credit FAQs November 25, 2020

On Wednesday, November 25, 2020, the IRS updated numerous frequently asked questions (FAQs) related to the tax credits for certain … Read More >

MO Medicaid Expansion

MO Medicaid Expansion in July 2021, Process Improvements Underway MO HealthNet with 660K residents enrolled will be expanding next July … Read More >

Two Final Rules on Drug Pricing

Two Final Rules on Drug Pricing On Friday, November 20, 2020, the Trump Administration issued two final rules related to … Read More >

FDA Covid-19 EUAs the Week of November 16, 2020

FDA Covid-19 EUAs the Week of November 16, 2020 The US Food & Drug Administration (FDA) had a busy week … Read More >

Wichita State University COVID-19 Testing for Employers

Wichita State University COVID-19 Testing for Employers Wichita State University's Molecular Diagnostics Laboratory (WSU MDL) has received grant money to … Read More >

San Francisco Health Care Security Ordinance 2021 Indexing and Poster

San Francisco Health Care Security Ordinance 2021 Indexing and Poster The City and County of San Francisco passed a law … Read More >

CDC Updated Guidance on Holidays and Travel

Holidays On November 11, the CDC published updated recommendations for the holidays that are meant to "supplement – not replace" … Read More >

Election Impact on Benefits

Election Impact on Benefits It appears former Vice President Joe Biden may have secured enough electoral votes to clinch the … Read More >

US Supreme Court Hears ACA Case Today

The US Supreme Court Hears ACA Case Today California v. Texas is now before the Supreme Court of the United … Read More >

CA: Proposition 22 Passes, Treating Gig Drivers as Independent Contractors

Proposition 22 Passes in California, Requiring App-Based Gig Economy Drivers to Be Classified as Independent Contractors In what was reportedly … Read More >

CO: Proposition 118 Passes, Creating New Paid Family and Medical Leave Program

New Paid Family and Medical Leave Program Passes in Colorado After multiple years of attempts by the Colorado legislature to … Read More >

Final Rule on Health Plan Price Transparency

Final Rule on Health Plan Price Transparency Last November, we published an alert discussing two rules that were issued in … Read More >

Interim Final Rule on COVID-19 Vaccines

Interim Final Rule on COVID-19 Vaccines During the public health emergency, the CARES Act mandates non-grandfathered health plans cover COVID-19 … Read More >

FSA and Commuter Limits Not Increasing for 2021

2021 FSA and Commuter Limits The IRS has published updates for 2021 limits to several tax code provisions.  As part … Read More >

DOL Updates MHPAEA Self-Compliance Tool

DOL Updates MHPAEA Self-Compliance Tool Under the 21st Century Cures Act, Congress directed federal regulators to issue a guidance document … Read More >

IRS Publishes Final 2020 ACA Reporting Forms and Instructions

IRS Publishes Final 2020 ACA Reporting Forms and Instructions On Friday, October 16, the IRS published final ACA reporting forms … Read More >

HHS Extends Public Health Emergency to January 2021

HHS Extends Public Health Emergency to January 2021 On Friday, October 2, the Department of Health and Human Services (HHS) … Read More >

IRS Extends Some Relief on ACA Reporting

IRS Extends Some Relief on ACA Reporting We are still waiting on final ACA reporting forms and instructions.  So on … Read More >