Compliance Corner

In this episode, Chase Cannon and Suzanne Spradley address recent IRS guidance that mandates electronic filing of certain tax forms – including Forms 1095-C – for smaller employers. Chase describes the background from Congress and the IRS and explains what it means now that any employer filing 10 or more forms (previously, this was 250) will be required to do so through the IRS electronic filing system. Suzanne and Chase discuss the impact on smaller employers, along with updated employer mandate penalties and certain state filing requirements for employers. Chase closes with an outline of a proposed bill in Congress addressing benefits continuation for employees locked out or participating in a strike.

Periodically, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page for the most up-to-date episode.

Topic: Spring Cleaning: Benefits Compliance 101

Description: It can be tricky to navigate the myriad of laws affecting benefit plans. Dust off the cobwebs and join us as we provide an overview of federal laws that affect benefits compliance.

Date/Time: April 19, 2023
2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET)

Register Now

This program is pending approval for 1.0 (general) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at hrci.org.

Under the CAA, Section 204, insured and self-insured group health plans are required to report significant information regarding prescription drug and healthcare spending to the government. The 2020 and 2021 calendar year data submissions were due by December 27, 2022. However, a submission grace period was made available to employers who submitted the 2020 and 2021 data in good faith on or before January 31, 2023.

The data must be submitted to the Health Insurance Oversight System (HIOS) in files and formats specified by CMS. As applicable, employers should work closely with their carriers, third-party administrators, pharmacy benefit managers and other vendors to ensure the required information is timely and accurately provided. In some cases, employers that sponsor self-insured plans may need to submit data directly to HIOS. Detailed information regarding the reporting requirements, including instructions, FAQs and a HIOS portal user guide, is available on the CMS website.

CMS recently released the 2022 RxDC Instructions. Employers should be aware that the reporting of 2022 data is due by June 1, 2023. Accordingly, carriers, TPAs and service providers submitting information on behalf of plans will be collecting required information from employers in advance of this deadline. Therefore, employers should respond promptly to requests for needed data, such as the average monthly premium paid by employers and employees, by any deadline set by the carrier, TPA or service provider. (Under limited regulatory relief, some plans were not required to report the average premium information for 2020 and 2021 but must do so for the 2022 reporting year.) Employers should also request written confirmation from the carrier, TPA or service provider of the timely submission.

Individuals who were HSA-eligible in 2022 have until the tax filing deadline to make or receive contributions. So, 2022 HSA contributions must generally be made by April 18, 2023. This includes employer contributions. The 2022 contribution limit is $3,650 for self-only coverage and $7,300 for any tier of coverage other than self-only. Those aged 55 and older are permitted an additional catch-up contribution of $1,000.

Generally, an individual’s maximum annual contribution is limited by the number of months they were eligible for the HSA. There is an exception to this rule. An individual who was HSA eligible on December 1 is permitted to contribute the full statutory maximum for the year. However, if eligible employees do not remain HSA eligible through December of the following year, they may experience negative tax consequences.

Individuals who contributed more than the allowable amount for 2022 should remove the excess contributions and associated earnings by April 18, 2023. The excess would be subject to income tax. If the employee fails to remove the excess contribution by the income tax filing deadline, an additional 6% penalty applies for each tax year the excess remains in the account. Employees who were not eligible for a contribution or contributed more than the allowable amount for 2022 should work with the HSA bank/trustee to process the excess contribution. Employees should consult with their tax advisors for specific tax advice and guidance.

For further information, please see IRS Publication 969 and our recent FAQ.

In this episode, Chase Cannon and Suzanne Spradley address recent IRS guidance that mandates electronic filing of certain tax forms – including Forms 1095-C – for smaller employers. Chase describes the background from Congress and the IRS and explains what it means now that any employer filing 10 or more forms (previously, this was 250) will be required to do so through the IRS electronic filing system. Suzanne and Chase discuss the impact on smaller employers, along with updated employer mandate penalties and certain state filing requirements for employers. Chase closes with an outline of a proposed bill in Congress addressing benefits continuation for employees locked out or participating in a strike.

Periodically, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page for the most up-to-date episode.

Topic: The End Is Near: Benefit Implications from Expiring COVID-19 Emergencies

Description: The COVID-19 emergencies are scheduled to end on May 11, 2023, signaling an end to benefit provisions employers have come to rely on in recent years. Join our team to learn how the end of these emergencies may impact your benefit plans. Topics we will cover include:

• The end of the extension of certain timeframes (the “outbreak period”)
• Certain special enrollment rights under HIPAA
• Changes to plan documents that may be needed

Date/Time: March 15, 2023
2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET)

Register Now

This program is pending approval for 1.0 (general) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at hrci.org.

Under the CAA, Section 204, insured and self-insured group health plans are required to report significant information regarding prescription drug and healthcare spending to the government. The 2020 and 2021 calendar year data submissions were due by December 27, 2022. However, under recently announced relief, a submission grace period was made available to employers who submitted the 2020 and 2021 data in good faith on or before January 31, 2023.

The data must be submitted to the Health Insurance Oversight System (HIOS) in files and formats specified by CMS. As applicable, employers should work closely with their carriers, third-party administrators, pharmacy benefit managers and other vendors to ensure the required information is timely and accurately provided. In some cases, employers that sponsor self-insured plans may need to submit data directly to HIOS. Detailed information regarding the reporting requirements, including instructions, FAQs and a HIOS portal user guide, is available on the CMS website.

Employers should be aware that the reporting of 2022 data is due by June 1, 2023. Accordingly, carriers, TPAs and service providers submitting information on behalf of plans will be collecting required information from employers in advance of this deadline. Therefore, employers should respond promptly to requests for needed data, such as the average monthly premium paid by employers and employees, by any deadline set by the carrier, TPA or service provider. (Under limited regulatory relief, some plans were not required to report the average premium information for 2020 and 2021 but must do so for the 2022 reporting year.) Employers should also request written confirmation from the carrier, TPA or service provider of the timely submission.

Annual ACA reporting deadlines for employers that sponsored group health plans in 2022 are approaching.

Applicable large employers (ALEs) with 50 or more full-time employees (FTEs), including full-time equivalent employees, in the prior year who sponsored group health plans (whether insured or self-insured) must comply with IRC Section 6056 reporting in early 2023. Specifically, ALEs must complete and distribute Form 1095-C to full-time employees by March 2, 2023. The form should detail whether the employee was offered minimum value, affordable coverage during 2022. The forms may be mailed, electronically delivered or delivered by hand (although proof of delivery in some manner is recommended).

Employers who sponsored a self-insured plan during 2022 must comply with Section 6055 reporting in 2023. Self-insured employers with 50 or more FTEs must complete Section III of Form 1095-C detailing which months the employee (and any applicable spouse and dependents) had coverage under the employer’s plan. If the self-insured employer has fewer than 50 FTEs, it must complete and distribute a Form 1095-B with such information. Again, the forms must be delivered to employees by March 2, 2023.

If the self-insured employer has fewer than 50 FTEs, an alternative is available to distributing Form 1095-B to individuals. These small employers are permitted to post a clear and conspicuous notice on their website of the availability of the document and the necessary contact information to request it. Any such request must be fulfilled within 30 days. This posting alternative is not available for Form 1095-C.

Employers must also file the forms with the IRS by February 28, 2023, if filing by paper, and March 31, 2023, if filing electronically. The filing must include the transmittal Form 1094-C (if filing Forms 1095-C) or Form 1094-B (if filing Forms 1095-B).

2022 Instructions for Forms 1094/1095-B »
2022 Instructions for Forms 1094/1095-C »
2022 Form 1094-B »
2022 Form 1095-B »
2022 Form 1094-C »
2022 Form 1095-C »

In this episode, Suzanne Spradley and Chase Cannon discuss potential activity at the federal and state level relating to PBM transparency. Suzanne begins the discussion by outlining a few proposals from Congress that attempt to hold PBMs accountable for unfair and deceptive practices that may be driving up prescription drug costs. Suzanne then addresses a few state proposals that attempt to regulate PBMs. Suzanne and Chase close by discussing the potential impact on employers and their group health plans.

Periodically, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page for the most up-to-date episode.

Topic: The End Is Near: Benefit Implications from Expiring COVID-19 Emergencies

Description: The COVID-19 emergencies are scheduled to end on May 11, 2023, signaling an end to benefit provisions employers have come to rely on in recent years. Join our team to learn how the end of these emergencies may impact your benefit plans. Topics we will cover include:

• The end of the extension of certain timeframes (the “outbreak period”)
• Certain special enrollment rights under HIPAA
• Changes to plan documents that may be needed

Date/Time: March 15, 2023
2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET)

Register Now

This program is pending approval for 1.0 (general) recertification credit hours toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at hrci.org.