Reminder: It’s MLR Rebate Time Again!
The ACA requires insurers to submit an annual report to HHS accounting for plan costs. If the insurer does not meet the medical loss ratio standards, they must provide rebates to policyholders. Rebates must be distributed to employer plan sponsors between August 1, 2021, and September 30, 2021. Employers should keep in mind that if they receive a rebate, there are strict guidelines as to how the rebate may be used or distributed.
Reminder: COBRA Subsidy Period Ends on September 30, 2021
The American Rescue Plan Act (ARPA) COBRA premium assistance period runs from April 1, 2021, to September 30, 2021. The statute requires that plans provide a notice of expiration of the ARPA premium assistance (and available coverage options at that point) to all individuals who are receiving premium assistance during this time. The notice states that plans and issuers are required to provide individuals with a notice of expiration of periods of premium assistance explaining that the premium assistance for the individual will expire soon, the date of the expiration and that the individual may be eligible for coverage without any premium assistance through COBRA continuation coverage or coverage under a group health plan. Coverage may also be available through Medicaid or the Health Insurance Marketplace.
This notice must be provided 15 – 45 days before the individual’s premium assistance expires, so employers should be mindful of this requirement.
Note: Distribution of the premium assistance notice of expiration is included in PPI's ARPA Subsidy Administration Service. COBRA clients who elected the Service can download the ARPA Update: Subsidy Ending September 30, for more information.
Reminder: Calendar Year SAR Must Be Distributed by September 30, 2021
Plans that are subject to ERISA and Form 5500 filing must distribute the Summary Annual Report (SAR) to participants within nine months of the end of the plan year; thus, a calendar year plan is generally required to distribute the SAR for the 2020 plan year by September 30, 2021. If the plan applied for an extension to the Form 5500 filing, the SAR is then due within two months following that filing.
The SAR is a summary of the plan’s information reported on the Form 5500. If a plan is not subject to Form 5500 filing, then it is exempt from the SAR notice requirement — this would include church plans, governmental plans, and unfunded or insured plans with fewer than 100 participants. Also, large, unfunded self-insured plans are exempt from the SAR requirement even though they are subject to the Form 5500 filing requirement.
For more information on how ERISA applies to PPI clients, download the Whitepaper ERISA as it Applies to PPI Clients.
Sample Model Language is available for your convenience.
Consolidated Appropriations Act, 2021: Mental Health Parity Requirements
The Consolidated Appropriations Act, 2021 (CAA) created an additional compliance obligation for plans that are subject to the Mental Health Parity and Addiction Equity Act (MHPAEA). Specifically, the CAA requires plans and insurance carriers to report how the nonquantitative treatment limitations imposed on mental health and substance use disorder benefits are in parity with those imposed on medical/surgical benefits.
The Benefits Compliance team has created a white paper, Consolidated Appropriations Act, 2021: Mental Health Parity Requirements, that provides a brief primer on MHPAEA and the CAA requirement and answers several questions that plan sponsors may have as they seek to comply with the law.
If a new employee takes leave during their waiting period, are they still eligible to begin coverage on their original effective date?
This material was created by PPI Benefit Solutions to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The service of an appropriate professional should be sought regarding your individual situation. PPI does not offer tax or legal advice. "PPI®" is a service mark of Professional Pensions, Inc., a subsidiary of NFP Corp. (NFP). All rights reserved.