Health Reimbursement Arrangements (HRA)

The US Department of Labor (DOL) is the responsible agency for overseeing compliance with ERISA, the Employee Retirement Income Security Act of 1974. Penalties for a variety of ERISA violations are contained within the law and are indexed annually for inflation. They've increased substantially.

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?

Like a horror movie scene, just when you thought that the Patient-Centered Outcomes Research Institute (PCORI) was finally funded from the plan years that began before October 1, 2018, it's baaaaaaacccckkkkk. And that means employers have new filings to make and fees to pay.

In two new IRS Notices (2020-29 and 2020-33), there are temporary changes to the rules governing Flexible Spending Accounts (FSAs) through 2020 due to COVID-19, and permanent changes to both FSAs and certain Health Reimbursement Arrangements (HRAs) that will begin this year. 

The DOL and IRS issued a Notice that announced a "pause" in the timelines that affect many COBRA and HIPAA Special Enrollment Period timelines during the COVID-19 National Emergency pandemic. It also provides for additional timelines relating to all health and welfare plan claim filings and appeals.

The Coronavirus Aid, Relief, and Economic Security Act (CARES) Act has now been signed into law on March 27, 2020. It is a mammoth bill of over 880 pages, and contains many employee benefit related items. This post deals with two health and welfare items: over-the-counter drugs and telemedicine.

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.

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.