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The Pay or Play Percentage Increase for 2025 | JRW Associates, Inc., a Raleigh Benefit Advisory

The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees.  The affordability rate for employer-sponsored health coverage will increase from 8.39% to … Continued

Departments Issue Further Guidance Under No Surprises Act | JRW Associates, Inc., a Raleigh Benefit Advisory

On September 30, 2021, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), released an interim final rule (IFR) under the No Surprises Act (Act) to help protect health care consumers from surprise billing and excessive … Continued

Requirements Related to Surprise Billing; Part I Interim Final Rule with Comment Period | JRW Associates, Inc., a Raleigh Benefit Advisory

On July 1, 2021, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM) released an interim final rule with comment period (IFC), entitled “Requirements Related to Surprise Billing; Part I.” This rule related to Title … Continued

DOL Issues Final Regulations Regarding Association Health Plans | JRW Associates, Inc., a Raleigh Benefit Advisory Firm

On June 19, 2018, the U.S. Department of Labor (DOL) published Frequently Asked Questions About Association Health Plans (AHPs) and issued a final rule that broadens the definition of “employer” and the provisions under which an employer group or association may be treated as an “employer” sponsor of a single multiple-employer employee welfare benefit plan … Continued

Proposed 2020 Benefit Payment and Parameters Rule | JRW Associates, Inc., a Raleigh Benefit Advisory Firm

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology. According to CMS, the proposed rule is intended to reduce fiscal and regulatory burdens associated with the Patient Protection and … Continued

DOL and IRS Release Additional Information on Association Health Plans | JRW Associates, Inc., a Raleigh Benefit Advisory Firm

On August 20, 2018, the Department of Labor (DOL) posted the Association Health Plans ERISA Compliance Assistance fact sheet. On August 20, 2018, the IRS added a new Q&A 18 to its Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act. Q&A 18 confirms that: An employer that is not an applicable … Continued

The Rap on Wraps | JRW Associates, Inc., a Raleigh Benefit Advisory Firm

There’s a good chance you use a wrap document to help satisfy your Employee Retirement Income Security Act (ERISA) summary plan description (SPD) obligations. Yet if you look for a definition of wrap document in ERISA statutes or regulations, you will not find one. The wrap is not a defined term or required document; it … Continued

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