STATE LEAVE LAW UPDATES MISSOURI On November 5, Missouri voters approved a new law mandating paid sick leave for employees in Missouri. Effective May 1, 2025, the new law applies to private employers of all sizes, with certain exceptions, such as interstate railroad employees, small local newspapers, and retail or service businesses with less than … Continued
As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit … Continued
On Sept. 9, 2024, the U.S. Departments of Health and Human Services (HHS), Labor (DOL), and the Treasury (IRS) (collectively, the Departments) released new final rules implementing the Mental Health Parity and Addiction Equity Act (MHPAEA). The final rule updates the way the Departments determine whether health plans treat mental health and substance use disorder … Continued
SUMMARY ANNUAL REPORT DUE The Summary Annual Report (SAR) is a disclosure requirement under ERISA. The SAR acts as a narrative of the Form 5500 for employee benefit plans. It includes financial statements, funding requirements, and participants’ rights. The SAR must be provided to participants and enrolled beneficiaries within nine months after the end of the plan … Continued
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
FEDERAL COURT BLOCKS FTC NON-COMPETE BAN NATIONWIDE: IMPORTANT INSIGHTS FOR EMPLOYERS On August 20, 2024, the U.S. District Court for the Northern District of Texas delivered a crucial ruling, effectively halting the Federal Trade Commission’s (FTC) Rule prohibiting most non-compete agreements. The Rule, which was set to go into effect on September 4, 2024, was … Continued
The Affordable Care Act (ACA) introduced the Medical Loss Ratio (MLR) to ensure that health insurance companies spend a significant portion of premiums on medical care and quality improvement activities rather than administrative costs and profits. When insurers fail to meet the MLR threshold, they are required to issue rebates to plan sponsors. Understanding MLR … Continued
FORM 5500 FILING FOR HEALTH AND WELFARE PLANS The Form 5500 series is a component of the Employee Retirement Income Security Act’s (ERISA) reporting and disclosure framework. The Form is used to report information on the qualification of the plan, its financial condition, investments, and its operations. It also guarantees that participants, beneficiaries, and regulators have access … Continued
ACA PREVENTIVE CARE MANDATE REMAINS IN PLACE WITH AN EXCEPTION In a recent decision, the U.S. 5th Circuit Court of Appeals upheld a key provision of the Affordable Care Act (ACA) that mandates private insurance cover preventive services without cost to patients. However, the court also ruled that the plaintiffs are exempt from complying with this mandate, … Continued
The Patient-Centered Outcomes Research Trust Fund fee, often referred to as the PCORI fee, can be a source of confusion for employers offering health insurance plans. This article aims to simplify what the PCORI fee is, why it exists, and how it impacts your business. What is the PCORI Fee? The PCORI fee is an … Continued
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