Health and Welfare Team

Employers that offer prescription drug benefits are required to provide an annual notice to all Medicare-eligible plan participants and qualified beneficiaries before October 15th of each year, the start of the Medicare open enrollment period. Most send it to all participants.

In August 2021 Delta Airlines announced that starting in 2022 it was imposing a $200 per month premium surcharge for any COVID-19 unvaccinated employee. Other employers quickly began asking if this was allowable under a myriad of employee benefit laws. The answer is "yes," but...

On the last possible workday on which to provide needed guidance before health plan sponsors had to fend for themselves on when the COBRA and HIPAA Outbreak Period ended, the Employee Benefits Security Administration, part of the US Department of Labor, issued Disaster Relief Notice 2021-01.

We provided information at the end of April, 2020 about the IRS' and DOL's determination that the "pause" button was hit on a number of regular timing and payment due dates relating to COBRA, health plan claims (including health care FSA claims), and HIPAA Special Enrollment Periods. Is it ending?

Much later than usual, the IRS released the 2020 retirement plan contribution limits. Earlier this year, they also released the High Deductible Health Plan (HDHP) and Health Savings Account (HSA) limits. We now also have the cafeteria plan, adoption credit, and transit benefit limits as well.

Since 2009, special enrollment rights to immediately enroll in an employer's health plan arise if an individual becomes eligible for a state premium assistance subsidy under Medicaid or the Children's Health Insurance Program Reauthorization Act ("CHIPRA", or often shortened to CHIP).

Under the ACA, the Patient-Centered Outcomes Research Institute (PCORI) was established. The funding mechanism for PCORI was a fee on group health plans, including certain employer-contributed health care flexible spending accounts (employer FSAs) and Health Reimbursement Arrangements (HRAs).

Kushner President and CEO Gary Kushner was invited to present a 5-minute (and exactly 5 minutes) speech at this year's DisruptHR conference. His topic was on "Total Rewards: Why are We Doing What We're Doing?" Here's the video of that talk.

The U.S. Department of Labor (DOL) recently published an Information Letter that confirms the general preemption under ERISA of state civil laws that require employers to obtain written consent before withholding amounts from employees’ wages for contribution to a benefit plan subject to ERISA.

Employers who sponsor group health plans that cover any prescription drugs generally must disclose whether the plan provides creditable or non-creditable prescription drug coverage to the Centers for Medicare and Medicaid Services (CMS) within 60 days of the start of a new plan year.

In a recent article published by SHRM, our President and CEO Gary Kushner was cited as the main resource on dealing with active employees and their dependents upon their reaching Medicare-eligibility. Kushner mentioned many issues related to employer-based health and prescription drug benefits.

On December 14, 2018, a US District Judge in Texas issued a ruling that the entire ACA was unconstitutional given that the individual mandate contained in it no longer had a tax penalty, the basis of the 2012 US Supreme Court ruling upholding the ACA's constitutionality.