Welfare Benefit Plan ERISA News
July 2013

Role of Health-Law 'Navigators' Under Fire
"Critics see the navigators as potential competitors to insurance brokers, and say that they are effectively federal government employees who should be subject to rigorous screening." (The Wall Street Journal)
"State of Disability"
If the number of U.S. citizens receiving federal disability benefits (10,962,532 people) was the population of a state, it would be the 8th largest state. There are more Americans collecting disability benefits than the combined populations of 11 states: Maine, New Hampshire, Rhode Island, Montana, Delaware, South Dakota, Alaska, North Dakota, Washington D.C., Vermont, and Wyoming. (Disabilities, Populations )
Are you GINA compliant?
"The EEOC's apparent new found interest in GINA does not come as a complete surprise, as its Strategic Enforcement Plan for 2012-2016 identified emerging and developing issues in equal employment law as one of its six national priorities, which includes genetic information. Employers should immediately cease from inquiring about an applicant's or employee's genetic information, unless such inquiry falls within one of GINA's narrow exceptions (inquiries in connection with employee wellness programs, genetic monitoring programs, or conducting DNA testing for law enforcement agencies)." Nixon Peabody
The latest ruling from HHS allows state, federal, and local agencies as well as health insurers to share PHI of anybody seeking to join the Exchanges, which will be enforced by the IRS. The ruling does not mention any requirement that applicants first OK the release of their PHI. The swapping of information is ostensibly meant to help figure the best insurance coverage of Obamacare users. Many are worried about how well the administration will protect that information in the aftermath of the IRS scandal and other leaks of government secrets.
Putting a Fine Point on PCORI Taxes

PCORI taxes are due by July 31 of the calendar year following the plan or policy year ending on or after October 1, 2012. Therefore, for years ending from 10/1/12 through 12/31/12, the first due date is 7/31/13, and for years ending from 1/1/13 through 12/31/13, the first due date is 7/31/14.

For insured plans, the carrier is responsible for paying PCORI taxes. However, for self-insured plans, the employer/Plan Sponsor is responsible. For these plans, the ERISA Plan Year, as stated in the SPD and Form 5500, should be used to determine the due date of IRS Form 720 and the number of participants upon which the tax will be calculated.
New Requirements for BAAs Due by 9/23/13
"As many employers know, HIPAA rules require them to sign Business Associate Agreements (BAAs) on behalf of their health plans with the vendors who assist in plan administration. Many employers also know that earlier this year, the U.S. Department of Health and Human Services issued final regulations which will require updated BAAs by September 23, 2013 or September 23, 2014, depending on the circumstances. Among the plans covered by these rules are medical flexible spending accounts, other than plans that are self-administered and have fewer than 50 participants." ERISA Wonk
ERISA Trivia

My company covers 128 participants in a self-insured medical plan, and we own specific and aggregate stop loss policies to protect us from high claims. Our employees pay their share of the cost through a cafeteria plan. We received a Schedule C from our TPA and a Schedule A from our Stop Loss Carrier. Do I need to file these schedules on our Form 5500? (Your answer)


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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.


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