September HR News Worth Review

By Higginbotham on September 10 , 2019


Medicare Part D Notices Due Before Oct. 15, 2019

Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before Oct. 15, 2019—the start date of the annual enrollment period for Medicare Part D. CMS has provided model disclosure notices for employers to use.

This notice is important because Medicare beneficiaries who aren't covered by creditable prescription drug coverage and don't enroll in Medicare Part D when first eligible will likely pay higher premiums if they enroll at a later date. Although there are no specific penalties associated with this notice requirement, failing to provide the notice may be detrimental to employees.

To make the process easier, employers often include Medicare Part D notices in open enrollment materials sent out annually. If a plan sponsor chooses to provide the disclosure notice with other plan participant information, the creditable coverage disclosure must be prominent and conspicuous. This means that the disclosure notice portion of the document or a reference to the section in the document that contains the disclosure notice portion must be prominently referenced in at least 14-point font in a separate box, bolded or offset on the first page of the provided plan participant information. Also, as a practical matter, group health plan sponsors often provide the creditable coverage disclosure notices to all plan participants.

Employer Takeaway
Employers should confirm whether their health plan’s prescription drug coverage is creditable or non-creditable and prepare to send their Medicare Part D disclosure notices before Oct. 15, 2019. “Before” means the individual must have been provided with the notice within the past 12 months. So, if it was provided on or after Oct. 16, 2018, that will suffice.

DOL Proposes Changes to FMLA Forms

The Department of Labor (DOL) recently proposed changes to the forms that are frequently used for administering employee leaves under the federal Family and Medical Leave Act (FMLA). The DOL is asking for the public to comment on the proposed revisions by Oct. 4, 2019.

According to the DOL, the proposed changes are intended to increase FMLA compliance and reduce the burden on employers, employees and health care providers by making the forms easier to use. The proposed changes would:

  • Reduce the number of questions that require written responses (and replace them with check boxes);
  • Reorganize the medical certification forms to simplify the determination of a serious health condition; and
  • Expand the instructions to clarify how to accurately complete the forms.

Employer Takeaway
Employers that use the DOL’s model FMLA forms should watch for developments related to these proposed changes. The draft revisions are in proposed form for comment only. At this point, they shouldn’t be used to administer FMLA leaves.

Preparing for 2020 Open Enrollment

To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2020. Employers should review their plan documents to confirm that they include these required changes. In addition, any changes to a health plan’s benefits for the 2020 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM). This is also a good time to review current policies and procedures around reporting and disclosure requirements under ERISA and other laws governing group health plans.

Employer Takeaway
Health plan sponsors should confirm that their open enrollment materials contain certain required participant notices, when applicable—the summary of benefits and coverage (SBC), for instance. There are also some participant notices that must be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials. Download our 2020 open enrollment checklist and list of required notices and disclosures for guidance.


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Tags: Compliance


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