In this episode, Chase Cannon and Suzanne Spradley step back from the ACA repeal-and-replace debate to explore a new trend in the U.S.: state paid family leave (PFL). PFL laws attempt to provide protection for employees who have to miss work because of a family’s medical emergency or similar family crisis. While the U.S. has generally been behind other countries, at the state level PFL benefits seem to be trending upwards. Chase and Suzanne explore several new state laws that provide paid family leave, including New York’s new paid family leave law that takes effect Jan. 1, 2018.
Tuesday, September 19, 2017
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Plans that are subject to ERISA and Form 5500 filing must distribute the Summary Annual Report (SAR) to participants within nine months of the end of the plan year; thus, a calendar year plan is required to distribute the SAR for the 2016 plan year by Sept. 30, 2017. If the plan applied for an extension to the Form 5500 filing, the SAR is then due within two months following that filing.
The SAR is a summary of the plan’s information reported on the Form 5500. If a plan is not subject to Form 5500 filing, then it is exempt from the SAR notice requirement — this would include church plans, governmental plans and unfunded/insured plans with fewer than 100 participants. Also, large, unfunded self-insured plans are exempt from the SAR requirement even though they are subject to the Form 5500 filing requirement.
Model language is available for SAR preparation — ask your advisor for assistance. For additional information, see the frequently asked question featured in the Aug. 23, 2016, edition of Compliance Corner.
PPACA requires insurers to submit an annual report to HHS accounting for plan costs. If the insurer does not meet the medical loss ratio (MLR) standards, they must provide rebates to policyholders. Rebates must be distributed to employer plan sponsors between Aug. 1, 2017, and Sept. 30, 2017. 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 to employees.
For more information, please contact your advisor for a copy of “Medical Loss Ratio Rebates: A Guide for Employers” or “Medical Loss Ratio: PPACA’s Rules on Rebates.”
While most employers focus on benefits compliance at the federal level, states have jumped in the game with their own rules and regulations. To help employers become more acquainted with the intricacies of these state rules, NFP’s Benefits Compliance team is holding a webinar miniseries in October focused on three particularly burdensome states: New York, the District of Columbia and California. For NY, a new paid family leave law takes effect on Jan. 1, 2018. D.C. and CA also have new laws that may impact any employer located or doing business in those states. Join us as we outline the rules in those states, including their impact on out-of-state employers. Each webinar below will begin at 3:00 p.m. ET and will last approximately one hour.
New York: Overview of Employer Obligations Under NY’s New Paid Family Leave Law
District of Columbia: Overview of D.C.-Specific Benefits Compliance Issues
California: Benefits Compliance Considerations for Employers Doing Business in California
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.
The notice must be provided to Medicare Part D-eligible individuals on an annual basis prior to Oct. 15, which is the first day of the Medicare enrollment period. Thus, the notice must be provided no later than Oct. 14 each year. Note that for 2017, since Oct. 14 falls on a Saturday, many employers should ensure that delivery of this notice has occurred by Friday, Oct. 13, 2017. It is recommended that the notice be sent to all employees who are eligible to participate in the employer’s medical plan.
This important notice assists eligible individuals in deciding whether to enroll in Medicare Part D prescription drug coverage. Because an individual can be eligible for Medicare due to age or disability, or an employee's spouse or dependent can be eligible for Medicare, it might be difficult for an employer to identify plan participants who are Medicare-eligible (and therefore must receive the Creditable/Non-Creditable Coverage notice). To avoid this difficulty (and for purposes of administrative simplicity), the recommended approach is for the notice to be distributed to all employees who are eligible to participate in the plan. The preferred method of delivery is first-class mail, although it is possible to distribute the notice electronically as long as certain conditions are met.
For more information, please contact your advisor for a copy of “Medicare Part D Guidance for Employer Deadlines.” You can also read more information about this requirement on the HR & Benefits Compliance Solutions website.