IMA Compliance Alert
Apr 30, 2018
April 30, 2018
Federal regulators have released final benefit and payment parameters for 2019. While mostly aimed at regulating insurers and the public health insurance Exchange Marketplaces, there are some elements impacting employer plans which we’d like to review for you below.
The premium adjustment percentage for 2019 is 25.16634051% (or about a 25% increase in premiums from 2013 to 2018). This reflects an increase of about 7.7% over 2018 (which was set around 16%).
In addition, States will have until July 2, 2018, to indicate how they’d like to change their essential health benefits (EHB) benchmark plans for 2020. With new flexibilities given to the States, we may see even more wide variations in EHBs from one State to another than we see already. While self-funded plans and large employer plans do not have to cover all 10 EHB categories, they do have to choose a State’s EHB benchmark plan and ensure any EHBs their plan covers abide by the following two requirements:
Please let your IMA Benefits team know if you have any questions.
IRS Reverses Change to 2018 HSA Family Contribution Limit
The IRS received a lot of stakeholder feedback about reducing the family HSA contribution limit by $50 after the calendar year had already begun (that announcement was in early March 2018). Due to the hardships this was causing, the IRS has now they will not reduce the family HSA contribution limit to $6,850 but will leave it at $6,900 for 2018. The making this official also provides instructions for those that
had already contributed the maximum and had to withdraw $50 plus earnings from their HSA.
For employers, this shouldn’t have much impact.
Paid FMLA Tax Credit Pilot Program for 2018 – 2019
Employers wishing to tax the new temporary tax credit for offering paid family and medical leave now have some very basic s available from the IRS. They don’t appear to provide any new information we didn’t already know, but here are some highlights of how the program works:
That’s the general framework, but future regulations will provide needed detail.
Mental Health Parity and Addiction Equity Act (MHPAEA)
The Department of Labor (DOL) Employee Benefits Security Administration (EBSA) and the Department of Health and Human Services (HHS) have been ramping up enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA). During these enforcement efforts, the Departments have also been providing health plans with guidance and tools needed to make sense of the often gray areas needing more clear guidance.
In 2018, the Departments have provided:
We continue to recommend working with your insurer or third party administrator (TPA) to ensure MHPAEA compliance as new guidance and tools are provided. Any request from plan participants or providers for MH/SUD benefits information should be responded to within 30 calendar days to avoid $110 per day penalty.
Grandmothered Plans
Back in 2013, President Obama’s administration announced that some non-grandfathered individual and small group health insurance plans would have to incorporate most but not all Affordable Care Act (ACA) requirements. Small group grandmothered plans could avoid these 3 key provisions:
The sunset date for allowing these plans to renew has been extended a few times, and regulators have another extension through plan years ending December 31, 2019.
As of the date of this latest announcement, 14 States and the District of Columbia no longer permit such plans. It’s possible this list may expand.