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Benefit Buzz - February 2024

Zywave, Inc • Feb 12, 2024

Benefit tips brought to you by MFC Benefits, LLC

Learn more about ACA Reporting deadlines and the DOL increases Civil Penalty Amounts for 2024.

ACA REPORTING DEADLINES ARE APPROACHING

Employers subject to Affordable Care Act (ACA) reporting under Internal Revenue Code Sections 6055 or 6056 should prepare to comply with upcoming reporting deadlines. For the 2023 calendar year, covered employers must:
•Furnish statements to individuals by March 1, 2024 (an alternative method of furnishing statements to covered individuals is available in certain situations).
•File paper returns with the IRS by Feb. 28, 2024 , or April 1, 2024 , if filing electronically. Beginning in 2024, employers who file at least 10 returns during the calendar year must file electronically.

Penalties may apply if employers are subject to ACA reporting and fail to file returns and furnish statements by the applicable deadlines. The following employers are subject to ACA reporting under Sections 6055 and 6056:
•Employers with self-insured health plans (Section 6055 reporting)
• Applicable large employers (ALEs) with either fully insured or self-insured health plans (Section 6056 reporting)

ALEs are employers with 50 or more fulltime employees (including full-time equivalent employees) during the preceding calendar year. Note that ALEs with self-insured plans are required to comply with both reporting obligations. However, to simplify the reporting process, the IRS allows ALEs with self-insured plans to use a single combined form to report the information required under both Sections 6055 and 6056.

DOL INCREASES CIVIL PENALTY AMOUNTS FOR 2024

On Jan. 11, 2024, the U.S. Department of Labor (DOL) published the 2024 inflationadjusted civil monetary penalties that may be assessed for a wide range of employee benefit-related violations.

To maintain their deterrent effect, the DOL is required to adjust these penalties for inflation no later than Jan. 15 of each year. Key penalty increases include the following:
• Summary of Benefits and Coverage (SBC) : Failure to provide group health plan participants and beneficiaries with an SBC may now result in a penalty of up to $1,406 per participant or beneficiary.
• Form 5500 filings : Failure to file an annual Form 5500 with the DOL can now result in a penalty of up to $2,670 per day.
• Children's Health Insurance Program (CHIP) notice : Failure to provide the annual notice regarding CHIP coverage opportunities may now result in a penalty of up to $141 per day (each employee is a separate violation).
• 401(k) disclosures : Failure to provide blackout notices and notice of the right to divest employer securities may now result in penalties of up to $169 per day.
• DOL-requested plan information : Failure to provide plan-related information requested by the DOL can now result in penalties of up to $190 per day but not to exceed $1,906 per request.

Provided to you by MFC Benefits, LLC

© 2024 Zywave, Inc. All rights reserved

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Benefit Buzz - May 2024

By MFC Benefits, LLC • 15 May, 2024

Learn more about the Prescription Drug Report due date and the Court Ruling on Free Preventive Care. PRESCRIPTION DRUG REPORT IS DUE BY JUNE 1, 2024 Group health plans must annually submit detailed information on prescription drug and health care spending to the federal government. This reporting is referred to as the "prescription drug data collection," or the "RxDC report." The next RxDC report is due by Saturday, June 1, 2024, covering data for 2023. Employers should confirm they are taking steps to comply with this reporting deadline, such as providing information to third-party vendors on a timely basis. The RxDC report is comprised of several files, including those that require specific plan-level information, such as plan year beginning and end dates and enrollment and premium data. It also includes files that require detailed information about medical and pharmacy benefits. RxDC reports must be submitted through an online portal maintained by the Centers for Medicare and Medicaid Services (CMS). CMS'RxDC website includes updated reporting instructions and other reporting resources. Employers commonly use third parties, such as issuers, third-party administrators (TPAs) and pharmacy benefit managers (PBMs), to submit RxDC reports on behalf of their health plans. Employers using third parties to submit RxDC reports must ensure that this reporting responsibility is reflected in a written agreement with the third party. Employers may work with multiple third parties to complete the RxDC report for their health plans. For example, a self-insured employer may use both its TPA and PBM to submit different portions of the RxDC report. A health plan's submission is considered complete if CMS receives all required files, regardless of who submits them. COURT RULING EXPECTED SOON ON FREE PREVENTIVE CARE The 5th U.S. Circuit Court of Appeals is expected to issue a decision within the next few months regarding the constitutionality of the Affordable Care Act's (ACA) preventive care mandate. The ACA requires non-grandfathered health plans and health insurance issuers to cover a set of recommended preventive services without imposing cost-sharing requirements, such as deductibles. In March 2023, the U.S. District Court for the Northern District of Texas struck down a key component of the ACA's preventive care mandate. More specifically, the court ruled that the preventive care coverage requirements based on an A or B rating y the U.S. Preventive Services Task Force on or after March 23, 2010, violate the U.S. Constitution. The Biden administration appealed the District Court's decision to the 5th Circuit. A ruling by the 5th Circuit is expected soon, likely followed by an appeal to the U.S. Supreme Court. It is uncertain whether the 5th Circuit will reverse or uphold the District Court's ruling. However, for now, non-grandfathered health plans and issuers must continue to cover, without cost sharing, the full range of preventive car services required by the ACA. If the 5th Circuit rules that a key component of the ACA's preventive care mandate is unconstitutional, employers will want to consult with their issuers or TPAs to assess the impact on their health coverage. Provided to you by MFC Benefits, LLC © 2024 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx