Benefits Compliance Podcast: Listen to the Latest Episode
October Get Wise Wednesdays – Register Now
Reminder: Medicare Part D Notice to Employees Is Due October 14, 2023
Reminder: It’s MLR Rebate Time Again!
CMS Issues Proposed Rules on No Surprises Act Federal Independent Dispute Resolution Process Fees
Fourth Circuit Focuses on Availability of Monetary Relief Under ERISA for Denied Heart Transplant
Comment Period on MHPAEA Proposed Rules Extended
Topic: Asking for a Friend: ERISA Fiduciary Edition
Employers, in their roles as ERISA health and welfare plan sponsors and administrators, must follow a fiduciary code of conduct that involves duties of loyalty, prudence, and impartiality. Join us for a webinar with the Benefits Compliance team, who will provide practical examples and insights regarding these fiduciary duties by addressing questions employers may be too embarrassed to ask.
Note: The speakers will answer as many questions as possible during the webinar. If your question isn’t answered, reach out to your advisor for further assistance.
Date/Time: October 18, 2023
3:00 to 4:00 p.m. ET
This program is pending approval for 1.0 (general) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at hrci.org.
Note: Those listening to a recorded webinar will not be eligible for credit.
Employers must notify individuals who are eligible to participate in their medical plan whether the plan's prescription drug coverage is "creditable" or "non-creditable" as compared to Medicare Part D coverage.
As a reminder, the Medicare Part D notice of creditable coverage should be distributed to employees by October 14, 2023. CMS provides a model notice for employers. The notice serves to inform Medicare-eligible individuals of whether or not their employer group coverage is creditable. This information can help such individuals avoid paying higher premiums (also known as late enrollment penalties) for Medicare Part D coverage.
Employers should consult with their service providers to determine whether their coverage is creditable using the simplified determination method or actuarial analysis.
For more information, please ask your advisor for a copy of our Medicare Part D Disclosures: A Guide for Employers publication.
The ACA requires insurers to submit an annual report to HHS to account for plan costs. If the insurer does not meet the medical loss ratio standards, this means too large a portion of the premiums charged in the previous year went towards the insurer’s administration, marketing, and profit, instead of going toward paying claims and quality improvement initiatives. In such case, the insurer must provide rebates to policyholders. For 2023, insurers must distribute rebates to employer plan sponsors between August 1, 2023, and September 30, 2023.
Employers should keep in mind that if they receive a rebate, there are strict guidelines as to how the rebate may be used or distributed. Generally, any portion of the rebate that is considered ERISA plan assets (e.g., the portion attributable to participant contributions) must be returned to participants in some form within 90 days of receipt.
For more information, please ask your advisor for a copy of our Medical Loss Ratio Rebates: A Guide for Employers publication.