Comply on the Fly

Did the COVID-19 National Emergency end? I thought it was supposed to end in May.  On April 10th, 2023, the federal government ended COVID-19 National Emergency. Allowing 60 days to the end of the outbreak period, this makes June 9, 2023 the official end date for deadline extensions. Tune in to this episode of Comply on the Fly to learn what this means for group health plan benefit purposes. _____...

I have an employee's spouse that will be going on Medicare soon. Should I offer COBRA? This episode of Comply on the Fly helps employers understand the interaction between Medicare entitlement and COBRA, which can be particularly complicated with Medicare's Secondary Payer Rules.  _____________________________ Turn to M3 and  Karen B. (Breitnauer)  for quick and timely answers to the most common e...

I have an employee who was recently divorced. He has removed his ex-spouse and dependents from the health coverage. In this situation, who do we send the COBRA election paperwork to?  This episode of Comply explores the nuances of COBRA-qualifying events triggered by divorce. Tune in to ensure your organization knows how to meet COBRA election paperwork provision requirements in situations of divo...

Do I need to do anything about air ambulance reporting?  The Air Ambulance Data Collection, or AADC, requirement seeks to give lawmakers and regulators a better understanding of the cost drivers behind large, surprise medical bills associated with air ambulance services. This episode of Comply covers the transparency and reporting requirements pertaining to air ambulance data. ____________________...

Do I have to offer enrollment to a person who loses eligibility for Medicaid due to a recent redetermination?  The Consolidated Appropriations Act of 2023 could result in some of your employees losing their Medicaid coverage. This episode of Comply on the Fly can help you, as an employer plan sponsor, prepare for this special enrollment event. _____________________________ Turn to M3 and  Karen B....

What is an ERISA SPD - and when do I need to provide it?  As a plan sponsor you are required to provide an SPD (Summary Plan Description) to your organization's employee benefit plan participants and beneficiaries informing them of their rights and benefits in relation to the plan offerings. This refresher episode of Comply on the Fly can help you, as an employer plan sponsor, better understand yo...

Can you tell me a bit more about the recent transparency guidance on gag clauses?  This episode of Comply on the Fly covers recent transparency guidance issued by the federal government pertaining to the prohibition of gag clauses in any agreements group health plans enter into with providers, TPAs (Third Party Administrators), and other network or associations of healthcare providers. ___________...

What did the Department of Labor, or DOL, recently say about FMLA and remote workers?  On February 9th, 2023, the Department of Labor Wage and Hour Division issued Field Assistance Bulletin 2023-1 addressing the application of FMLA eligibility requirements to remote employees. This episode of Comply on the Fly provides covers what employers need to know about this bulletin. _______________________...

It's not really a question per se, but you may be wondering about the end of the COVID National Emergency or public health emergency and how this will affect your group health plans.   The President of the United States recently issued a "statement of administration policy" declaring the discontinuation to the COVID-19 national emergency. This episode of Comply on the Fly provides information on h...

What is the difference between a conditional opt-out arrangement and an unconditional opt-out arrangement?  Opt-out arrangements (historically called cash-in-lieu arrangements) provide a taxable cash payout if an employee waives employer-sponsored health insurance. This episode of Comply on the Fly covers both unconditional and conditional opt-out arrangements and the additional compliance obligat...

This week's episode features another client-direct FMLA question: "I have an employee who is pregnant and due in August. She is having complications with her pregnancy and missing work. I have sent her the FMLA paperwork, however, she has not returned any of it. She indicated that she's off due to being sick from the pregnancy and has brought in notes from her doctor taking her off of work. Can I...

We had two companies with common ownership. However, in June 2022, one of the companies was sold off to a separate entity and therefore we are no longer part of a controlled group. As per the ACA requirements - Affordable Care Act requirements - we included both entities in determining whether or not we were over 50 full-time and full-time equivalents. Each entity separately now has 35 and 40 empl...

Can a dependent of an employee open their own HSA or health savings account?  Individuals who meet certain criteria and coverage conditions are eligible to establish and contribute to their own HSA (Health Savings Account). This episode of Comply on the Fly helps employer plan sponsors understand if and when a dependent of an employee may be eligible for their own HSA. ____________________________...

By policy, our limited term employees can only work 1,200 hours in a calendar year, which is less than the 30 hours per week, which is 1,560. If an LTE, meaning 'Limited Term Employee', begins work in the second half of the calendar year and then continues to work in the first half of the next year, are we required to offer insurance since they have worked more than 30 hours per week during the lo...

Are there any guidelines or best practices around how to identify possible intermittent FMLA situations or when supervisors should notify HR of a potential need? Intermittent leave tends to be one of the most difficult things for employers to deal with in regards to FMLA. This episode of Comply on the Fly offers tips for identifying and managing intermittent FMLA leave. ___________________________...

What is the difference between special enrollment and Section 125 qualifying events? Special enrollment quite often gets confused with Section 125 qualifying events. Karen B. outlines the difference for employers in this refresher episode of Comply on the Fly. _____________________________ Turn to M3 and  Karen B. (Breitnauer) for quick and timely answers to the most common employee benefits compl...

I was wondering for an employee that starts in December and doesn't become benefit-eligible until January 1st, 2023, do I still need to create a 1095C for them showing a 1H/2D?  In this Comply on the Fly Karen B. responds to this client question pertaining to ACA reporting pertaining to 1095Cs. If you also have questions on this, tune in to find answer.  _____________________________ Turn to M3 an...

As an employer, what do I need to know about the coding and forms around Affordable Care Act (ACA) reporting for 2022? In this Comply on the Fly Karen B. responds to an influx of questions she is currently receiving as employers prepare to do their ACA reporting for 2022. Tune in to find answers to your questions on this topic.  _____________________________ Turn to M3 and  Karen B. (Breitnauer) f...

How do we ensure that an employee working seven and a half hours per day for 180 days per year and making $15 and 25 cents an hour is offered affordable coverage for both single and family coverage?  In this Comply on the Fly Karen B. helps employers with 50 or more employees determine if their offers of coverage are affordable according to the ACA (Affordable Care Act) Shared Responsibility requi...

I have a couple of people that will be using FMLA leave and won't go through it all before January 1st. Is there anything I need to do since we run FMLA on a calendar year basis? Or do I just keep tracking it?   In this Comply on the Fly Karen B. answers a timely client question on if FMLA leave rolls over or resets with the change of the calendar year. Tune in to learn how to track and maintain p...

Our employee and the spouse are on the spouse's health plan. We, as the employer, have an open enrollment period for July 1 start date, and the spouse's employer has an open enrollment period for a January 1 start date. Our open enrollment period is over, but the spouse's open enrollment period is now open. Can the spouse drop all enrollments during their open enrollment, and can the family now ju...

We hire many variable hour employees and we move them to full-time status when they work more than 30 hours per week. Is this correct?  In this Comply on the Fly Karen B. addresses a client concern around proper classification of employees in regard to the Affordable Care Act Shared Responsibility rules. If you are an employer subject to these ACA rules, tune in to learn how to avoid penalties for...

Do we need an SPD for dental coverage as well as medical?  In this Comply on the Fly Karen B. answers this client question, covering alignment of SPDs & benefit plan documents in medical, dental and self-funded plan scenarios. Tune in to learn how to keep the plan documentation for your unique situation compliant. _____________________________ Turn to M3 and  Karen B. (Breitnauer) for quick an...

When I am completing my 1095Cs, do I need to enter a code on part II, line 16 when someone waives coverage? Karen B. is back with Season 2 of Comply on the Fly!  This episode covers how to properly fill out 1095c forms in regard to full time employees who waive your offers of coverage. Tune in to learn how to avoid errors that could result in an IRS penalty letter. _____________________________ Tu...

Our employee is covered under his spouse's high deductible health plan at another employer. Our employee is not enrolled in our high deductible health plan. The employee's spouse has an HSA or Health Savings Account. The question is, can our employee contribute to the HSA of the spouse? This final episode of Comply on the Fly, Season 1 covers three scenarios around an employee contributing to the...