New Mandatory Preventive Items and Services, 2022 Updates
Most plans will be required to cover new preventive items and services beginning later this year or in 2023 (depending on the plan year), including ones…
New Prescription Drug Reporting Requirement
As previously reported in December 2021, Section 204 of the Consolidated Appropriations Act, 2021 (“CAA”) requires plan sponsors of group health plans to…
IRS Announces 2023 ACA Affordability Indexed Amount
The IRS recently announced in Revenue Procedure 2022-34 that the Affordable Care Act (“ACA”) affordability indexed amount under the Employer Shared…
Further Guidance Issued on Contraceptive Coverage
On July 28, 2022, the Departments of Labor, Health and Human Services and the Treasury (collectively, “the Departments”) issued FAQ Part 54 to clarify…
2023 Inflation Adjusted Amounts for HSAs
The IRS released the inflation adjustments for health savings accounts (“HSAs”) and their accompanying high deductible health plans (“HDHPs”) effective for…
HHS Extends Public Health Emergency Until July 15, 2022 (Downloadable PDF)
On April 12, 2022, the Secretary of Health and Human Services (“HHS”) renewed the COVID-19 pandemic Public Health Emergency, effective April 16, 2022. This…
Temporary Telehealth Relief for HSA Plans (Downloadable PDF)
On March 15, 2022, the President signed government funding legislation, the Consolidated Appropriations Act, 2022 (“CAA- 22”), into law. The legislation…
No Surprises Act IDR Process Altered by Court Order (Downloadable PDF)
Under the No Surprises Act (“NSA”), when out-of-network (“OON”) providers cannot agree to a payment amount from insurers, the payment amount is determined by…
Annual Out-of-Pocket Maximum Adjustments Announced for 2023 (Downloadable PDF)
On December 28, 2021, the Department of Health and Human Services (“HHS”) published the “payment parameters” portion of its Annual Notice of Benefit and…
Additional Guidance Addresses ACA Preventive Care Mandate (Downloadable PDF)
As part of FAQ 51, the Departments of Labor, Health and Human Services, and the Treasury (together, the “Departments”) issued guidance clarifying several…
New PCOR Fee Announced (Downloadable PDF)
On December 21, 2021, the IRS released Notice 2022-04, announcing that the adjusted applicable dollar amount used to determine the PCOR fee for plan years…
OSHA’s Emergency Temporary Standard: Guidance on Mandatory COVID-19 Vaccination/Testing (Downloadable PDF)
UPDATE: On December 17, 2021, in a 2-1 decision, the 6th Circuit Court of Appeals allowed the Occupational Safety and Health Administration’s (“OSHA”)…
Final 2021 Instructions for Forms 1094-C and 1095-C Issued (Downloadable PDF)
The IRS released final Instructions for Forms 1094-C and 1095-C for calendar year 2021 reporting. Background Applicable large employers (“ALEs”) must furnish…
New Jersey Releases 2022 Disability and Family Leave Amounts (Downloadable PDF)
New Jersey has announced the 2022 contribution rates and benefit level parameters for the Temporary Disability Insurance (“TDI”) and Family Leave Insurance…
2022 Cost of Living Adjustments (Downloadable PDF)
The IRS recently released cost of living adjustments for 2022 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may…
Guidance Clarifies Outbreak Period Rules for COBRA (Downloadable PDF)
Recently, the Internal Revenue Service (“IRS”), in coordination with the Departments of Labor and Health and Human Services (collectively, “the Departments”),…
HHS Issues Guidance Addressing HIPAA and COVID-19 Vaccinations (Downloadable PDF)
The Department of Health and Human Services (“HHS”) issued guidance in the form of questions and answers addressing how the HIPAA Privacy Rule applies in…
Telehealth Relief for HDHPs Set to Expire (Downloadable PDF)
The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) was signed into law on March 27, 2020. Among other things, the CARES Act offered…
Surprise Medical Billing Guidance Clarifies IDR Process and Fees (Downloadable PDF)
On September 30, 2021, the Departments of Health and Human Services (“HHS”), Labor (“DOL”), and the Treasury (collectively, “the Departments”) jointly…
FAQs Address COVID-19 Vaccine Group Health Plan Incentives (Downloadable PDF)
On October 4, 2021, the Departments of Labor, Health and Human Services, and the Treasury (together, the “Departments”) issued FAQ Part 50 addressing several…
2021 MLR Rebate Checks Recently Issued to Fully Insured Plans (Downloadable PDF)
As a reminder, insurance carriers are required to satisfy certain medical loss ratio (“MLR”) thresholds. This generally means that for every dollar of premium…
Medicare Part D Notification Requirements
Employers sponsoring a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as to…
IRS Announces 2022 ACA Affordability Indexed Amount (Downloadable PDF)
The IRS recently announced in Revenue Procedure 2021- 36 that the Affordable Care Act (“ACA”) affordability indexed amount under the Employer Shared…
Some Transparency in Coverage and CAA Deadlines Delayed (Downloadable PDF)
On August 20, 2021, the Departments of Health and Human Services (“HHS”), Labor (“DOL”), and the Treasury (collectively called “the Departments”) jointly…
More Employers May Be Required to Electronically File Some IRS Forms (Downloadable PDF)
On July 23, 2021, the IRS issued proposed rules that would significantly expand the number of employers required to electronically file information returns…
HHS Extends Public Health Emergency until October 18, 2021 (Downloadable PDF)
On July 19, 2021, the Secretary of Health and Human Services (“HHS”), announced that the administration will renew the COVID-19 pandemic Public Health…
Additional Guidance Issued on the 2021 COBRA Subsidy (Downloadable PDF)
On July 26, 2021, the IRS released Notice 2021-46 providing additional guidance on the 2021 COBRA premium assistance (or “COBRA subsidy”). The 2021 COBRA…
ARPA Subsidy: New Notice Required for Small New Jersey Employers (Downloadable PDF)
The New Jersey Department of Banking and Insurance recently issued Bulletin No. 21-08, which establishes a new notice requirement for small employers of fully…
Request for Information on Pharmacy Transparency (Downloadable PDF)
The Consolidated Appropriations Act, 2021 (“CAA”) imposes new reporting requirements related to pharmacy benefits and prescription drug costs that apply to…
Supreme Court Dismisses Latest Challenge to the ACA (Downloadable PDF)
Background The “individual mandate” provision of the ACA as originally enacted in 2010 required most U.S. residents to obtain minimum essential health…
New Mandatory Preventive Items and Services – 2021 Updates (Downloadable PDF)
Most plans will be required to cover new preventive items and services beginning later this year, or in 2022 or 2023 (depending on the plan year),…
2021 PCOR Fee Filing Reminder for Self-Insured Plans (Downloadable PDF)
The Patient-Centered Outcomes Research (PCOR) fee filing deadline is August 2, 2021, for all self-funded medical plans and HRAs for plan years ending in…
Conducting a Pay Analysis
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) According to Kenneth Eade, a lawyer and author, “In any negotiation, the one who…
IRS Provides Additional Guidance on the COBRA Subsidy – Downloadable PDF
On May 18, 2021, the IRS issued 86 FAQs regarding implementation of the 2021 COBRA premium assistance (or “COBRA subsidy”) and corresponding tax credit…
2022 Inflation Adjusted Amounts for HSAs – Downloadable PDF
The IRS released the inflation adjustments for health savings accounts (HSAs) and their accompanying high deductible health plans (HDHPs) effective for…
Annual Out-of-Pocket Maximum Adjustments Announced for 2022 – Downloadable PDF
On April 30, 2021, the Department of Health and Human Services (“HHS”) published its Annual Notice of Benefit and Payment Parameters for 2022. This…
Employers Encouraged to Provide PTO for Vaccinations – Downloadable PDF
On April 21, 2021, President Biden issued an announcement to encourage all employers to offer paid time off for employees to schedule vaccinations and…
Guidance Issued on MHPAEA Comparative Analysis Requirement – Downloadable PDF
As previously reported, the Consolidated Appropriations Act, 2021 (“CAA”) amends the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”) to…
Update on COVID-19 Vaccine and Vaccine Administration Cost – Downloadable PDF
Medicare has increased and simplified its payment rate for administration of the COVID-19 vaccine to $40 per dose. This change may impact group health…
COVID-19 PPE Now a Qualified Medical Expense – Downloadable PDF
On March 26, 2021, the IRS issued IRS Announcement 2021-7, which clarifies that amounts paid for certain personal protective equipment (“COVID-19 PPE”) used…
Conducting a Human Resource Assessment
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) A regular review of your human resource operations is imperative in order to keep…
New COBRA Subsidy – Downloadable PDF
Congress passed the American Rescue Plan Act of 2021 (“the Act”) on March 10, 2021 and it was signed into law on March 11, 2020. The Act includes a 100%…
2021 Guidance Issued on Outbreak Period – Downloadable PDF
Summary: On February 26, 2021, the Departments of Labor and the Treasury (“the Departments”) issued guidance addressing the COVID-19 Outbreak Period –…
Difficult Communications During COVID-19
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) Having difficult conversations about work performance, attendance, and…
Marketplace Special Enrollment Period Announced – Downloadable PDF
On January 28, 2021, in response to the COVID-19 pandemic, • President Biden issued an executive order requiring the U.S. Department of Health and…
Reminders for Medicare CMS Notice and 1094-1095 Filing – Downloadable PDF
Medicare Part D – CMS Notification Reminder Employers sponsoring a group health plan (whether insured or self-insured) need to report information on the…
DOL Penalties Increase for 2021 – Downloadable PDF
The Department of Labor (DOL) published the annual adjustments for 2021 that increase certain penalties applicable to employee benefit plans.…
New Jersey Issues 2020 Individual Mandate Reporting Requirements – Downloadable PDF
The State of New Jersey has provided information for employer reporting for the 2020 calendar year under New Jersey’s individual health insurance mandate…
HHS Extends the Public Health Emergency Again – Downloadable PDF
On January 7, 2021, the Secretary of Health and Human Services (“HHS”) announced the administration will renew the COVID-19 pandemic Public Health…
EEOC Provides Proposed Wellness Rules – Downloadable PDF
On January 7, 2021, the Equal Employment Opportunity Commission (“EEOC”) released two notices of proposed rulemaking (“Proposed Rules”) on wellness…
DOL FAQs Address Expiration of FFCRA Leave – Downloadable PDF
On the last day of 2020, the Wage and Hour Division of the Department of Labor (“DOL”) issued two additional FAQs (#104 and #105) related to the Families…
Different Ways You Can Express Gratitude at Work
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) Individual achievement and competition are rewarded in US workplaces through…
Top Ten Tips To Have More Effective Meetings
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) What words come to mind when you think of workplace meetings? Efficiently run…
What to Know About New Jersey Transit Commuter Tax Benefits (Updated Oct 2020)
Updated: October 26th, 2020 On March 1, 2019, New Jersey established a transit benefit ordinance that requires employers to offer employees pre-tax commuter…
2020 HR Trends: HR Advantage Advisory Update
(Article originally authored by HR/Advantage Advisory, Powered by Clark Hill) The US workforce has encountered unprecedented changes over the past few months.…
Department of Labor: Updated Family & Medical Leave Act Forms
The Department of Labor’s Wage and Hour Division (WHD) has released new forms for the Family and Medical Leave Act (FMLA). The new forms are intended to reduce…
New Jersey ACA 1095 Reporting & Mandate Filing Deadline
If you are an employer and provide your staff with health insurance coverage, you need to be aware of the New Jersey state individual mandate that comes into…