This is a busy time of year for businesses that have employer-sponsored group plans. There are many deadlines that are looming before the end of the year and into 2016. As a business, you’ll want to make sure that you file everything that is required on time. Here is a handy, non-exhaustive timeline of upcoming deadlines to help keep you on track:
October 15, 2015: Medicare Notice of Creditable Coverage
Employers who sponsor health plans that include prescription drug benefits for active employees or retirees who are Medicare-eligible must provide an annual notice that explains whether their drug benefit is “creditable coverage,” meaning that it is expected to cover, on average, as much as the standard Medicare Part D prescription drug plan. The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan.
November 1, 2015: Health Insurance Open Enrollment
This is the yearly period when people can enroll in a health insurance plan. For 2016 coverage, the Open Enrollment Period is November 1, 2015 – January 31, 2016. People may qualify for Special Enrollment Periods allowing them to enroll outside of Open Enrollment if they have certain life events, like getting married, having a baby, or losing other coverage.
November 16, 2015: Transitional Reinsurance Enrollment
Section 1341 of the Affordable Care Act established a transitional reinsurance program to stabilize premiums in the individual market inside and outside of the Marketplaces. The transitional reinsurance program will collect contributions from contributing entities to fund reinsurance payments to issuers of non-grandfathered, Affordable Care Act-compliant reinsurance-eligible individual market plans, the administrative costs of operating the reinsurance program, and the General Fund of the U.S. Treasury for the 2014, 2015, and 2016 benefit years. The deadline for submitting enrollment numbers for the calculation of the transitional reinsurance fee is November 15, 2015.
November 16, 2015: Transitional Reinsurance Second Installation Fee
Those who opted to pay the 2014 Transitional Reinsurance Fee in two installments must make the second installment of $10.50 per covered life by November 15, 2015. The 2015 TRF is $44 per enrollee, which can be paid either in one installment due by January 15, 2016, or in two installments, with $33 per enrollee due by January 15, 2016, and $11 per enrollee due by November 15, 2016.
November 15, 2015: Form 990
The deadline for exempt organizations (Voluntary Employee Beneficiary Associations or “VEBAs”) to submit the IRS Form 990, Return of Organization Exempt from Income Tax, is November 15, 2015.
November 15, 2015: Form 8868
This deadline applies to organizations following a calendar tax year and who previously filed IRS Form 8868, Application for an Extension of Time to File an Exempt Organization Return.
December 15, 2015: Summary Annual Report to Employees
Plan administrator must provide employees with a copy of their plan’s Summary Annual Report by December 15, 2015.
December 15, 2015: Marketplace/Exchange Coverage
Individuals must be enrolled in Marketplace/Exchange coverage for it to be effective January 1, 2016.
December 30, 2015: MLR Rebates
ERISA plan sponsors who received MLR rebates on September 30 must pay the appropriate rebate amount to participants or for benefit improvements if the rebate is in part “plan assets,” or employer must establish a trust to hold the rebate as plan assets.
December 31, 2015: Corrections to Cafeteria Plan Non-Discrimination Failures
Section 125 Cafeteria Plans for Pre-Tax Premiums designates that a plan cannot discriminate in favor of highlight compensated individuals (HCIs). A plan that provides greater benefits to HCIs is a top-heavy plan and will not pass the required nondiscrimination tests. Cafeteria Plans, which failed nondiscrimination testing under Code Section 125, and Dependent Care Assistance Programs, which failed nondiscrimination testing under Code Section 129, have until December 31, 2015, to correct those errors.
January 31, 2016: ACA Employer Responsibility Information Reporting
The first ACA employer responsibility information returns are not due to individuals until January 31, 2016, and to the IRS by February 28 (March 31 if filed electronically), however, employers must track and collect 2014 and 2015 data that will be used for those submissions. Employers are required to include the social security numbers of employees, spouses, and covered dependents. Social security numbers are preferred, but if a social security number is not available, you may use an employee’s date of birth instead. Congress has increased the penalties for failing to comply with these new reporting requirements. Failing to furnish the required form, on time can result in penalties up to $250 per failure (previously $100), subject to a calendar year maximum of $3,000,000 (previously ($1,500,000).
Other Year-End Reviews
Wellness Program Review: The Equal Employment Opportunity Commission (EEOC) has been actively taking legal action against employers over wellness programs that it considers coercive under the Americans with Disabilities Act (ADA). While the EEOC rules are not final, employers sponsoring wellness programs should evaluate their existing wellness program to ensure the highest return on investment.
Cost-Sharing and High Deductible Review: Plan sponsors should carefully evaluate their out-of-pocket limits to ensure that plans comply with both Health Care Reform limits and, if the plan is intended to work with Health Savings Accounts, with High Deductible Health Plan (HDHP) limits.
Compliance Review: Employers should conduct annual reviews of plan documents and operational practices, including eligibility provisions (relating to employer responsibility rules), compliance with notice requirements, evaluation of preventive care coverage, and eligibility rules for same-sex spouses and determine if they are still taxing benefits provided to same-sex spouses.
Opt-out Payment Review: Employers should review the impact of the guidance, stating that “cash-in-lieu” or “opt-out” payments in a group health plan may have to be taken into account when calculating affordability under ACA, on their existing opt-out payments and potential penalties.
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