Q. A COBRA continuant says he is disabled and wants an additional 11 months of COBRA coverage due to disability. Does he have to show proof of his disability within any specific time frame?
Group health plans that offer prescription drug benefits to individuals who are eligible for Medicare Part D must inform those participants as to the creditability of their coverage. For an employer’s prescription drug coverage to be creditable, it must be, on average, at least as good as Medicare Part D coverage. This means the actuarial value of the employer’s coverage must equal or exceed the actuarial value of standard Medicare Part D coverage.
IRS Publication 5208 provides guidance for an employer to use to determine if it is an Applicable Large Employer (ALE) under the Affordable Care Act. ALEs must provide minimum essential, affordable coverage or be subject to a tax penalty. ALEs must also comply with health care reform reporting requirements.
Q.- We are thinking of changing to a self-funded plan. How will we determine the amount to charge COBRA continuants?
Last week, the Equal Employment Opportunity Commission (EEOC) issued proposed rules describing how employer wellness programs can be structured to satisfy the Americans with Disabilities Act. Wellness programs with disability-related questions and/or medical examinations must not run afoul of the ADA.
The United States Department of Labor, Health and Human Services and Treasury issued two Frequently Asked Questions (FAQs) on implementation of the Affordable Care Act. These FAQs address how wellness programs can comply with health care reform.
Q.- We have a participant who had dental work done when she was in Mexico. She paid out of pocket. Can she submit her receipt for reimbursement from her Health FSA?
A recent court decision out of the Eastern District of New York found that posting a summary plan description (SPD) on a company Intranet did not satisfy the electronic disclosure rules under ERISA. A SPD is considered properly distributed only if the communication satisfies Department of Labor Regulations.
The Department of Health and Human Services has released 2016 values for health care reform premium stabilization programs and cost sharing requirements.
Q. Our union employees are transferring to a Taft Hartley Plan. Do we have to offer them the right to continue our health coverage under COBRA?
The District of Columbia’s new Wage Theft Prevention Amendment Act took effect earlier this year. The Act requires employers to provide certain notices to employees and increases employer liability for wage and hour violations.
An applicable large employer (ALE) must offer affordable minimum essential coverage that provides minimum value to its full-time employees and their dependents or pay a tax penalty. Each separate employer member of the ALE group will be responsible for its own shared responsibility payment.
Q.- We are firing two employees because they used our tools and started a competing business on company time. We think this is gross misconduct. Do we have to offer them COBRA?
Last week, the U.S. Supreme Court held in Young v. UPS that employers may be required to accommodate pregnant employees, but the Court did not look favorably on the EEOC’s recent pregnancy guidelines.