We’ve outlined six compliance tasks to help your organization close out the 2022 year with a strong sense of compliance confidence. View the resources and steps below to ensure your organization stays on top of their compliance obligations and end the year with peace of mind.
Prepare for Affordable Care Act (ACA) Reporting
Now is the time to start having your organization think about how to tackle ACA reporting and consider options to secure a third-party vendor if they do not plan to complete the reporting in-house.
All applicable large employers (ALE) must file paper Forms 1094-C and 1095-C with the IRS by February 28 or file electronically by March 31.
ALEs must also furnish a copy of the 1095-C to all full-time employees by March 2.
Determine What COVID-19 Related Laws Still Apply
Since the inception of the COVID-19 pandemic, the government has taken steps to mitigate its impact and provide relief. This led to a surge of legislation and guidance that either temporarily or permanently changed the landscape for health and welfare benefits. Some of these changes were mandatory while others were optional for health plans to adopt. To add to the complexity, many of these deadlines were extended to deal with the ongoing pandemic creating further administrative challenges for health plans and issuers.
Provide Medicare Part D Creditable Coverage Notice by October 15
Medicare open enrollment period runs from October 15 through December 7.
To ensure Medicare-eligible individuals have information about the creditable coverage of their employer sponsored prescription drug plan, employers must provide notification by October 15.
To determine whether coverage is creditable, annually, businesses should work with their carrier, TPA, or vendor to review their prescription drug plan using generally accepted actuarial principles and following Centers for Medicare and Medicaid Services (CMS) guidelines. Typically carriers will perform this analysis for fully insured plans but the employer retains responsibility for distribution of the notice.
Complete Nondiscrimination Testing to Avoid Income Tax Surprises
Under the Section 105(h) and Section 125 nondiscrimination rules, an employer is prohibited from discriminating in favor of highly compensated individuals.
In some instances, an employer may impose class differentiations that are permissible under the HIPAA nondiscrimination rules that may not comply with the Sections 105(h) and 125 rules if it discriminates in favor of highly compensated individuals.
Update Plan Documents with Benefit Changes
If your organization is making any changes to their benefits package for next year, assess whether these changes impact existing ERISA, Section 125, and Section 105(h) plan documents, requiring the distribution of a Summary of Material Modification (SMM).
Prescription Drug Transparency Reporting
The new reporting requirement requires group health plans and issuers to submit information on prescription drugs and health care spending by December 27, 2022, and annually after that on June 1, 2023.