Benefits Insights

If you are 73 or older, remember to take your Required Minimum Distributions from any retirement plan or IRA you may have.  As discussed in prior blog posts, Required Minimum Distributions (“RMDs”) are taxable amounts that account owners must withdraw annually if they meet the age requirement of 73.  Failure to take an RMD on time may result in ...

Effective January 1, 2025, Kentucky has new law regulating pharmacy benefit managers (“PBMs”).  Earlier this year, the Governor of Kentucky signed SB 188 into law, making Kentucky the latest state to pass legislation regulating PBMs.  The new law applies to PBM contracts issued, renewed, extended, or amended on or after January 1, 2025.

SB ...

The SECURE 2.0 Act of 2022 (SECURE 2.0) made numerous changes to the complex web that makes up U.S. retirement plan laws.  Of interest to S corporations that may be considering an employee stock ownership plan (ESOP) is the expansion of Section 1042 of the tax code to permit a 10% tax deferral for certain sales to S corporation ESOPs.

Section 1042 has ...

Last month, the IRS released the 2025 cost-of-living adjusted limits for health savings accounts (HSAs) and high-deductible health plans (HDHPs). The IRS requires that in order to contribute to an HSA, an individual must be enrolled in a HDHP plan that meets the minimum deductible requirements. The minimum deductible is the amount a ...

If you were born before 1951, remember that you must take your required minimum distributions (RMDs) from funds held in individual retirement arrangements (IRAs) and other retirement plans before the end of the year.

RMDs are amounts that account owners must withdraw each year once they reach their required beginning date, currently age 72.  RMDs ...

Last week, the IRS announced it was increasing enforcement strategies aimed at Employee Stock Ownership Plans “ESOPs". The IRS stated this new focus on ESOPs is part of the effort to ensure tax laws are applied fairly and that high-income filers pay the taxes they owe. As part of this initiative, the IRS Commissioner commented that the IRS is ...

Last month the Sixth Circuit Court of Appeals upheld a lower court ruling that a company’s benefits committee did not properly delegate decision-making authority to its benefits department. As a result, the plaintiff’s appeal was reviewed under the de novo standard of review (which allows the court to conduct an independent analysis of ...

If you sponsor a self-insured group health plan (including an HRA), make sure you set a calendar alert for July 31 to pay the annual PCORI fee (Patient-Centered Outcomes Research Institute fee) for the 2022 plan year. The PCORI fee and the related IRS Form 720 are due no later than July 31st. The updated form can be found here, and the PCORI fee is reported ...

If you are not offering a supplemental executive retirement plan (“SERP”) to your officers and executives, you likely have to answer “no” to the above.  Since a SERP is designed to supplement other retirement benefits offered by an employer, such a plan can help an executive increase their income during retirement which may not be met by ...

On Monday, April 10, President Biden on Monday signed a bill which immediately ended the Covid-19 National Emergency, first enacted during the Trump administration in 2020. The National Emergency (“NE”) and COVID-19 Public Health Emergency (“PHE”) have been in place since early 2020, and gave the federal government flexibility to ...

Our webinar series continues on SECURE 2.0, the latest legislation passed by Congress at the end of 2022. Building on the success of the original SECURE Act of 2019, this new legislation aims to further expand access to retirement accounts, promote participation, and preserve savings. Our experts broke down the key provisions of SECURE 2.0 and ...

This week, the IRS issued proposed regulations regarding the use of forfeitures in qualified retirement plans, including 401(k) plans.  The proposed regulations include a deadline for the use of forfeitures in defined contribution plans and clarify the purposes for which forfeitures can be used in a defined contribution plan. The regulations ...

At the end of last year, Congress passed, and President Biden signed, the new appropriations bill which contained the SECURE 2.0 Act.  The legislation provides numerous changes that impact retirement plans and is an expansion of the earlier SECURE Act law.  The previous SECURE Act changed the age at which retirees had to take required minimum ...

As previously discussed in this blog, the waiver for no-cost telehealth services provided to HSA participants enacted as part of the CARES Act in 2020 was set to expire.  As part of the recently passed omnibus spending bill, the waivers will be extended until December 31, 2024.  Originally, the waivers were set to expire 60 days after the end of the ...

As discussed in prior blog posts, the PCORI Fee was resurrected by the IRS in 2019.  This past week, the IRS updated the amount of the PCORI Fee for policy years and plan years that end on or after October 1, 2022, and before October 1, 2023.  The new amount of the PCORI Fee is $3.00 per covered life.  That is a $.21 increase from the prior year.

As a reminder ...

Late last week, the IRS released its annual update for the cost-of-living adjustments for retirement plans. As predicted based on the overall rate of inflation, there are widespread increases for 2023.  As shown below, almost all IRS limits were affected by this year’s cost-of-living adjustments, including catch-up contributions.

Now that ...

Earlier this week, the IRS issued a final rule meant to close the “family glitch” for Affordable Care Act (“ACA”) subsidies on the Federal Healthcare Exchange.  This “glitch” prevents family members from receiving ACA subsidies if someone in their household has access to an employer-sponsored health plan that meets the ACA’s ...

As mentioned in our prior post, numerous benefit plan-related deadlines were extended by the DOL when it declared a National Emergency due to COVID-19 in March, 2020.  By law, the National Emergency continues until: (1) emergency is not continued by the president; (2) the president terminates it; or (3) a joint resolution of Congress terminates ...

If you sponsor a self-insured group health plan (or an HRA), make sure you set a calendar alert for July 31 to pay the annual PCORI fee (Patient-Centered Outcomes Research Institute fee) for the 2021 plan year. The PCORI fee and the related IRS Form 720 are due no later than July 31st. The updated form can be found here, and the PCORI fee is reported on Part ...

As discussed in our prior blog post, the DOL has recently been more receptive to permitting retirement plan fiduciaries to consider Environmental, Social, and Governance issues (“ESG”) when considering investment funds.  The DOL’s tentative acceptance of ESG factors in the last few years mirrors an increased participant demand for ...

Recently, the U.S. Labor Department issued new guidance regarding the holding or investing in cryptocurrency by 401(k) retirement plans.  This new guidance specifically impacts retirement plans that permit participants to use self-directed brokerage accounts to trade individual stocks on their own.

Under the new guidance ...

As mentioned in our prior blog post, effective January 1, 2022 for calendar year plans, the ability of HSA plans to cover telehealth at 100% is ending.  If you have not already amended your plan to account for this expiration, you should do so now.  Any amendment will need to require plans to charge a reasonable fee for telehealth and apply any fees to ...

Earlier this month, the US Department of Labor (“DOL”) issued a proposed rule that would reverse their own 2020 interpretation of the fiduciary investment rules.  The proposed rule would allow fiduciaries managing the investments for retirement plans to choose investments while also considering environmental, social, and governance ...

Last year the IRS provided guidance that permitted telehealth services to be offered under high-deductible health plans on a pre-deductible basis.  Plan sponsors were permitted to amend their plan documents so participants could receive telehealth services at no cost or at a cost less than the normal deductible. This meant those individuals ...

As discussed in our prior blog post, the No Surprises Act requires non-grandfathered group health plans offering coverage to disclose information regarding in-and out-of-network rates for certain covered items and services and prescription drugs in machine-readable files on a publicly available website. The machine-readable file ...

As discussed in our prior blog post, employer-sponsored health plans must soon provide pre-exposure prophylaxis (“PrEP”) drugs as a preventive service under the Affordable Care Act (“ACA”).  This means the HIV drugs must be offered at no cost to participants for all participants at risk for HIV exposure beginning in the 2021 plan year by ...

At the end of 2020, the No Surprises Act was enacted to provide protection against surprise medical bills.  Earlier this month, an interim final rule containing guidance for the new law was issued by Health and Human Services.  According to the release that accompanied the new guidance, under the new law, “Patient cost-sharing, such as ...

Today, in a 7-2 decision, the U.S. Supreme Court dismissed a challenge to the Affordable Care Act.  The decision leaves the law intact and allows approximately 31 million individuals to keep their coverage under the ACA.  The suit had been brought by several Republican-led states and the former Trump administration, and sought to have the entire ...

Earlier this week, the IRS issued Notice 2021-31 which provides some much sought after guidance on the new COBRA subsidy in the form of FAQs.  As part of this new guidance, the IRS provided some clarity on the definition of “involuntary termination” for purposes of eligibility for the subsidy. The guidance emphasizes the determination of an ...

Earlier this month, in response to a recent federal report recommending guidance to eliminate cybersecurity risks to retirement plans, plan participant data, and plan assets, the Employee Benefits Security Administration division of the DOL (“EBSA”) published cybersecurity guidance for ERISA-covered retirement plans. The ...

As discussed in our previous post, Congress recently passed a 100% subsidy for certain individuals who enroll in COBRA continuation coverage.  Today, the DOL issued FAQs to answer several of the questions raised by the new subsidy.

As a reminder, the subsidy provides that assistance eligible individuals are not required to pay their COBRA ...

Earlier today, Congress passed the American Rescue Plan Act (“ARPA”).  The bill will now go to President Biden for signature.  Under ARPA, eligible COBRA enrollees will be able to receive a 100% subsidy for their COBRA premiums. The subsidy will be provided by the federal government via payroll tax credits for employers.  The House had ...

In our recent post, we discussed the EEOC’s newest proposed wellness program rules under the ADA and GINA.  As of this week, those proposed rules have been formally withdrawn by the EEOC.  The proposed rules were posted unofficially on the EEOC’s website but were not published in the Federal Register before President Biden took office.

As part of ...

Recently, the EEOC finally released their proposed wellness regulations.  These regulations replace regulations that were released in 2016 but were withdrawn by the EEOC in 2019 due to court challenges and confusion.  These new proposed regulations address wellness programs under both the Americans with Disabilities Act (“ADA”) and the ...

Congress passed, and the President finally signed, the Consolidated Appropriations Act, 2021 (“CAA”).  This bill, the fifth longest bill to be passed in the history of Congress, contains over seventy new tax policies, extensions, refinements, and other tax-law clarifications.  Within its over 5000 pages is The Taxpayer Certainty and ...

As discussed in our prior post, last July the Department of Labor (“DOL”) and Health and Human Services (“HHS”) released proposed rules regarding grandfathered health plans.  Earlier this month, the two agencies issued the final grandfathered plan rules.  The final rules follow the proposed rules with no substantive changes.

As a ...

As discussed in our prior blog posts, the PCORI Fee was resurrected by the IRS last year.  This past week, the IRS updated the amount of the PCORI Fee for policy years and plan years that end on or after October 1, 2020, and before October 1, 2021.  The new amount of the PCORI Fee is $2.66 per covered life.  The fee for plan years ending prior to October 1, 2020 ...

Earlier this fall, the Departments of Health and Human Services, Treasury, and Labor (the “Departments”) issued the final rule for “transparency in coverage” requirements for health plans and insurers.  The final rule applies to most non-grandfathered group health plans and health insurance issuers will be required to comply with ...

The CARES Act extended the due date for making 2020 contributions to a defined benefit plan to January 1, 2021.  In IRS Notice 2020-82, the IRS has now clarified that the 2020 contributions will be treated as timely if made by January 4, 2021, the first business day after January 1, 2021.

In response, the PBGC immediately adjusted its prior guidance ...

Many times, when faced with a possible compliance issue, plan sponsors will debate whether they should call their benefits attorney or not.  While attorneys wish this wasn’t the case, it is understood.  Fixing compliance issues costs money.  No one likes to spend money.  An attorney will tell you the risk depends on the circumstances and ask your ...

Last week, in a 2-1 decision, the Sixth Circuit Court of Appeals allowed DaVita Inc’s lawsuit against a health plan and its administrator to continue.  In its suit DaVita alleges the plan discriminates against patients with end-stage renal disease (“ESRD”).  Under the terms of the self-insured health plan, all dialysis providers were ...

This is the time of the year when open enrollment occurs for many health plans.  This is also the time of year when you can meet many of your annual legal notice responsibilities.  Open enrollment is a busy time of year so it is a good idea to get into the habit of giving out your annual notices at the same time.  This means there is one less thing to forget later ...

As discussed in our previous posts, earlier this summer the PBGC issued FAQs that gave plan sponsors until October 15, 2020, to make their 2019 contributions and have that contribution reflected in the calculation of the variable rate premium due on that date.  Under the FAQs, any contributions made for 2019 after the October 15, 2020 deadline could ...

As discussed in a prior blog post, the CARES Act allows defined benefit plan sponsors to delay any minimum required contribution for 2020 until January 1, 2021.  However, the CARES Act did not delay the filing deadline for a plan’s Form 5500.  This means that if a plan sponsor delays the contribution, as allowed by the CARES Act, to a date that falls ...

Earlier this week the IRS issued proposed regulations regarding an extension of the rollover period for certain plan loan offset amounts.  The proposed rules implement portions of the Tax Cuts and Jobs Act (“TCJA”), which provides for an extended rollover period for a Qualified Plan Loan Offset (“QPLO”), which is a type of plan loan ...

As discussed in a prior blog post, the Department of Health and Human Services’ Office for Civil Rights’ (“OCR’s”) issued its revised interpretation of Section 1557 of the Affordable Care Act (“ACA”). OCR’s revised interpretation eliminated “gender identity” from the list of protected classes. As At almost the same time ...

The Coronavirus Aid, Relief and Economic Security (“CARES”) Act extended the deadline for making 2019 defined benefit plan contributions to January 1, 2021.  At the end of last month, the Pension Benefit Guaranty Corporation (“PBGC”) issued new FAQs to clarify when the 2019 contribution must be made in order for it to be reflected in ...

Earlier this week, members of health plans for two different employers filed a potential class action lawsuit against United Healthcare regarding cross-plan offsetting.  This case comes nearly 18 months after United lost a similar case before the 8^th Circuit Court of Appeals brought by care providers.  This new case, Scott et al. v ...

Earlier this month, the Department of Labor (“DOL”) and Health and Human Services (“HHS”) released a proposed rule which provides more flexibility for grandfathered health plans to change cost-sharing requirements.  A grandfathered health plan is generally a group health plan that has continuously provided coverage since March 23 ...

Last month, the U.S. Department of Health and Human Services (“HHS”) issued its final rule under Section 1557 of the Affordable Care Act that rescinded certain protections afforded to LGBTQ individuals and persons with limited English proficiency. In the same rule, HHS also removed burdensome disclosure requirements for health plans.  Only ...

Last month, the IRS issued a proposed rule that would expand the ability of health reimbursement accounts (“HRAs”) to reimburse employees tax-free for care or expenses from direct primary care arrangements (“DPCA”) and health care sharing ministries (“HCSM”).  The proposed rule would allow payments for DPCA and for membership in ...

In what seems like ages ago, back in the summer of 2019, the United States Preventive Services Task Force (“USPSTF”) recommended that health plans cover pre-exposure prophylaxis (“PrEP”) for persons who are at high risk of HIV acquisition.  Under the Affordable Care Act (“ACA”), USPSTF recommendations must be covered by ...

As discussed in our prior blog posts, the PCORI fee, thought dead in 2019, was reinstated and the amount updated.  Knowing the new fee amount of $2.54 was step one.  However, plan sponsors who wanted to move beyond step one could not because the IRS had not revised the Form 720.

Fortunately, late last week, the IRS did update the Form 720.  You can find the ...

As mentioned in our blog post last week, while the PCORI fee has been resurrected by the IRS, the amount of the fee for plan years ending after October, 2019 had not been updated.  Today, the IRS released Notice 2020-44 which updates the fee amount and provides some limited transition relief.

The new amount used to calculate the PCORI fee for policy ...

If you are feeling a sense that the rules around benefits haven’t changed enough in the last three months, this is a reminder of a change made during the long ago time of December 2019.  In those ancient times, the PCORI fee rose from the dead.  We all thought the annual PCORI (Patient-Centered Outcomes Research Institute) was set to expire back in 2019 ...

Earlier this month, the DOL released its first updates to the model COBRA Notices since 2014.  The new notice does not reflect any legal changes, but instead provides more information regarding the interaction of COBRA and Medicare. The new notices explain there may be advantages to enrolling in Medicare rather than COBRA.  And it highlights that ...

Among the many pages of DOL issued guidance and relief for plan sponsors one provision has avoided a lot of attention.  In Notice 2020-21, discussed in some of our other blog posts, in addition to the extension of certain time frames, the DOL provided an extension of deadlines for providing retirement and welfare plan notices to participants.

The ...

To echo my colleague in another post, in nearly 20 years of practice I have never seen so much benefits related guidance in such a short period of time. It seems like just yesterday the IRS and DOL issued a joint notice providing some deadline relief for COBRA and HIPAA related matters.  Today, we receive more complex guidance when the IRS released Notices

This week the DOL and IRS issued a joint rule which provides relief from certain deadlines for group health plans, other welfare benefit plans, and retirement plans. The guidance applies to all plans covered by ERISA or the Code, and HHS has announced it will extend similar relief to non-federal governmental health plans.  This post examines the ...

This past week, the Pension Benefit Guaranty Corporation (“PBGC”) announced it had extended deadlines for upcoming premium payments and other filings due to the COVID-19 pandemic.  The PBGC’s announcement came after the IRS extended its deadlines to July 15, 2020.  Under the PBGC’s disaster relief policy, when the IRS announces ...

Most small businesses are aware of the loans backed by the Small Business Administration (“SBA”) to help maintain cash flow and retain workers, specifically the Paycheck Protection Program (“PPP”).  While most of the media, and our prior blog post, focused on how to apply for these loans and the fact the loan is forgivable if used for ...

Earlier today, the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act was passed by the House.  Having already passed the Senate, the CARES Act will now go the President, who has stated he will sign it as soon as possible.  The Act is far reaching for nearly every aspect of American life and business.  This post focuses on the portion of ...

Earlier today, the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act was enacted into law when it was signed by the President.  The Act is far reaching for nearly every aspect of American life and business.  This post focuses on Sections 2202 and 2203 of the Act which provide relief for participants and plan sponsors of defined ...

The Ohio Department of Health today ordered health insurers to provide leeway to employers and employees to help meet the challenges of the coronavirus with regard to coverage and premium payments. The Order was made pursuant to Governor DeWine’s emergency declaration of March 9, 2020 and will remain in effect until the end of the emergency.

As discussed in our other coronavirus related blog posts, new legislation intended to ease the economic consequences stemming from the novel coronavirus disease (COVID-19) outbreak by expanding FMLA and sick leave available to employees and providing tax credits to employers providing the leave has been passed. The legislation also ...

While leave-sharing programs are common in the public sector, many private sector employers have not yet embraced these programs.  For many, the tax issues involved with such a program are more trouble than they are worth.  In an attempt to find a silver-lining to the current health situation, this post examines how the current national emergency ...

On March 11, 2020, the IRS issued Notice 2020-15 which announced that high deductible health plans (“HDHP”) may offer testing and treatment for COVID-19 without co-pays or deductibles.  Plan sponsors are not required to offer these services without cost-sharing but are permitted to do so if they choose.

Notice 2020-15 provides that an HDHP ...

As we continue our review of the SECURE Act, we turn our attention to a new optional provision that is designed to help defray the costs of adoption and child-birth. This new distribution option was created when the SECURE Act expanded the list of items excluded from the additional income tax on early distributions contained in IRC Section 72(t).

This continues our series of posts regarding the SECURE Act of 2019.  As discussed in our previous articles, Cadillac Tax Sent to the Junkyard… and 72 is the New 70 ½ for RMD’s…, the SECURE Act has made numerous changes to taxes, health plans, and, now, even retirement plans.

Effective for plan years beginning after December 31, 2020, the SECURE ...

As employers head into open enrollment season for health insurance there are numerous legal notices that must be provided to eligible employees.  One of those annual notices was recently revised and a new model notice was provided by the Department of Labor’s Employee Benefit Security Administration.

The model Medicaid/CHIP notice was revised ...