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Straight From The Source Blog by Higginbotham Insurance


September HR News Worth Review

September 10 , 2019

 HR-News-Blog

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.

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Tags: Compliance


August HR News Worth Review

July 31 , 2019

 HR-News-Blog

IRS Expands Preventive Care for HDHPs to Include Chronic Conditions

On July 17, 2019, the IRS released Notice 2019-45 to add care for a range of chronic conditions to the list of preventive care benefits that can be provided by a high deductible health plan (HDHP) without a deductible. This includes treatment and medication for asthma, diabetes, heart disease and depression, among others.

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Tags: Compliance


July HR News Worth Review

July 08 , 2019

 HR-News-Blog

Dallas and San Antonio Paid Sick Leave Starts Accumulating on August 1st

This past legislative session, the Texas Legislature failed to pass laws preempting paid sick leave ordinances that were passed by municipalities. While a similar ordinance in Austin was ruled unconstitutional by the Court of Appeals – and also enjoined from being implemented – no such legal actions have been filed with regards to the ordinances in Dallas and San Antonio. While it is likely that litigation will still be filed up until the August 1st implementation date, the lack of any such suits leaves employers with no choice but to prepare accordingly. Therefore, Dallas and San Antonio employers (and even companies based elsewhere with employees in those cities) should review their current leave policies to make sure that leave accumulation and utilization is handled correctly starting on August 1, 2019 (August 1, 2021 for small employers with less than five employees.)

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Tags: Compliance


Final Rule on Employer-Sponsored HRAs for Individual Coverage Released

June 21 , 2019

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Tags: Compliance


June HR News Worth Review

June 13 , 2019

 HR-News-Blog

PCORI Fees due by July 31

With summer in full swing, July 31 will be here before you know it. On or before that date, some employers will need to file an Internal Revenue Service (IRS) Form 720 and submit the applicable payment for their Patient Centered Outcomes Research Institute (PCORI) fees.

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Tags: Compliance


How to count employees for compliance purposes

June 05 , 2019

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Full-time. Part-time. Seasonal. The variety of work arrangements can make getting an employee count complicated – and that’s before you even deal with turnover rates. Despite the difficulty, knowing how many employees your organization has is important for legal reasons. Exactly how to count your employees depends on the legal purpose of the count.

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Tags: Compliance


May HR News Worth Review

May 16 , 2019

 HR-News-Blog

President Announces Plan to Combat Surprise Medical Billing, HHS Moves for More Drug Pricing Transparency

On May 9, 2019, President Donald Trump delivered a speech criticizing the practice of surprise medical billing. He announced a general plan of attack and hinted at a few specifics for curbing the trend.

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Tags: Compliance


April HR News Worth Review

April 08 , 2019

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Federal Court Strikes Down Association Health Plan Rules; DOJ Supports Federal Court Ruling Invalidating the ACA

On Dec. 14, 2018, a federal judge ruled in Texas v. Azar that the entire Affordable Care Act (ACA) is invalid due to the elimination of the individual mandate penalty in 2019. In response, on March 25, 2019, the U.S. Department of Justice (DOJ) filed a letter with the Fifth Circuit Court of Appeals agreeing with the lower court’s ruling. This means that the DOJ believes the lower court’s ruling should stand, and the ACA should be struck down as unconstitutional.

Following the ruling, however, the federal judge issued a stay and partial final judgment in the case. As a result, the ACA will remain in place pending appeal. The Department of Health and Human Services (HHS) also confirmed that it will continue administering and enforcing all aspects of the ACA.

Then, on March 28, 2019, a federal district court invalidated key parts of the Trump administration’s 2018 final rule on association health plans (AHPs). The court directed the Department of Labor (DOL) to consider how the remaining provisions of the final rule are affected by its decision.

In its ruling, the court stated that the final rule was an “end-run” around the ACA and that the DOL exceeded its authority under ERISA. The court specifically struck down two parts of the final rule:

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Tags: Compliance


March HR News Worth Review

March 20 , 2019

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DOL Issues New Proposal on Overtime Rule

On March 7, 2019, the Department of Labor (DOL) issued a proposed rule that would change the salary thresholds for the “white collar” overtime exemptions under the Fair Labor Standards Act (FLSA).

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Tags: Compliance


February HR News Worth Review

February 20 , 2019

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Medicare Part D Disclosures due March 1 for Calendar Year Plans

Group health plan sponsors are required to complete an online disclosure form with the Centers for Medicare & Medicaid Services (CMS) on an annual basis and at other select times to indicate whether the plan's prescription drug coverage is creditable or non-creditable. This disclosure requirement applies when an employer-sponsored group health plan provides prescription drug coverage to individuals who are eligible for coverage under Medicare Part D.

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Tags: Compliance


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