News & Updates:
New Flex Plan News for Employers
Major Topics:
- New Age 26 Dependent Rule & Impact on Benefit Plans
- New Red Flags Rule Applicable to Cards June 1
- Update on ProBenefits COBRA Administration
- ProBenefits Announces New Form 5500 Preparation Service
- Client Webinar Series Continues
- Flex Card Update
- Q&A: How will the new 2011 OTC drug rule affect my Health FSA?
ProBenefits Client Webinar Series: HRAs & 105 Plans – August 17, 2010
You are invited to participate in a webinar on Tuesday, August 17th at 2:00 pm. This webinar is designed to provide plan advisors with a detailed overview of HRAs and 105 plans (including deductible reimbursement plans). We will discuss trends we are seeing in the market and focus on key plan design options that may assist you as you advise your clients on new and creative ways to manage a medical benefits program.
Presenters will be: Jason Cogdill (Benefits Attorney), Jamie Rorrer (Benefits Consultant), and Charles Crabbe (Benefits Consultant)
An invitation will come soon by email. If you are not on our email list and would like to attend, contact us at Flex@ProBenefits.com. Feel free to share the invitation with others that may be interested.
Title: HRAs and 105 Plans – A Closer Look
Date: Tuesday, August 17, 2010
Time: 2:00 PM - 3:00 PM EDT
ProBenefits Client Webinar Series - COBRA Update - May 11, 2010
You are invited to participate in a webinar on Tuesday, May 11th at 2:00 pm. This webinar is designed to provide employers and advisors with an overview of current COBRA rules, including the COBRA premium subsidy.
Presenters will be: Jason Cogdill (Benefits Attorney) and Jessi Lawson (COBRA Administrator)
Instructions on how to attend the webinar are below. Feel free to share the invitation with others that may be interested. If you have questions, please contact us.
Title: COBRA Update
Date: Tuesday, May 11, 2010
Time: 2:00 PM - 3:00 PM EDT
Space is limited. Reserve your Webinar seat now at:
https://www2.gotomeeting.com/register/636146634
After registering you will receive a confirmation email containing information about joining the Webinar.
September 3, 2009 - ProBenefits Now Offers COBRA Administration
ProBenefits recently introduced a new COBRA administration service. This service is in addition to our existing FSA, HRA, and POP administration and is designed to provide another level of benefit plan compliance and support for employers. ProBenefits COBRA is a full-service product that includes administration of COBRA for all group health plans sponsored by the employer. The service features an automated web product, efficient employer reporting, handling of all notices to qualified beneficiaries, premium billing and collection, and dedicated client service and compliance assistance.
Our goal is to combine an automated COBRA service with the ProBenefits model of client service and compliance support. Jessi Lawson is our dedicated COBRA administrator and oversees the day-to-day administration for all COBRA clients. Our in-house benefits attorney, Jason Cogdill, provides compliance assistance for COBRA clients and plan advisors. We are excited about COBRA as our newest service, and we plan to work hard to provide the best full-service COBRA product available. For more information or to have ProBenefits administer COBRA for your group plans, discuss with your benefits advisor or contact us directly.
August 25, 2009 - New Flex Plan News Available
Major Topics:
- Health Care Reform Update
- ProBenefits Now Offers COBRA Administration
- New Red Flag Rule Regarding Identity Theft
- New Webinar Option for FSA Enrollment Meetings
July 20, 2009 - ProBenefits Hosts Health Care Reform Webinar
ProBenefits hosted a Health Care Reform webinar on Monday, July 20th at 2pm. This session included an update on the health care reform process, including specifics about the recently-introduced Senate and House bills as well as a discussion of key issues and ways you can be heard as the process continues. Presenters from ProBenefits were Gary Knight (President) and Jason Cogdill (Benefits Attorney).
ProBenefits has been very active in the health care reform process both on our own and through coordinated lobbying efforts in Washington. Our goal is to help inform you of current developments as well as arm you with information to participate in the process if you elect to do so.
Download the slides from the webinar here (PDF).
June 23, 2009 - ProBenefits Meets With Congressional Representatives Regarding Health Care Reform
On Monday, June 22, Gary Knight, President of ProBenefits, and Jason Cogdill, Corporate Counsel, traveled to Washington to meet with the offices of several Congressional representatives regarding health care reform and specifically the current challenge to the tax status of employer-provided benefits. Gary and Jason met with the Healthcare Legislative Correspondent from the staffs of Senator Richard Burr (R-NC), Senator Kay Hagan (D-NC), Representative Heath Shuler (D-NC), and Representative Bob Etheridge (D-NC). They also met directly with Representative Virginia Foxx (R-NC) and her Healthcare Legislative Correspondent. Jason and Gary stressed the importance of account-based benefit plans (FSAs, HRAs, and HSAs) and the valuable role they play in the current employer-based system. They also emphasized that any cap of the "employer exclusion" would have an adverse effect on account-based plans which would result in a tax increase to many working Americans.
ProBenefits continues its effort to stay involved regarding the health care reform process, as this is a pivotal time for employers and employees. We will do our best to keep you informed, and we encourage you to communicate with your representatives and let them hear from you on the issues.
June 6, 2009 - July 1st is Retail IIAS Deadline
The IRS deadline (IRS Notice 2008-14) for pharmacies and retail merchants to have an IIAS (Inventory Information Approval System) in place is June 30. As of July 1, only retail merchants with IIAS will be able to accept the Flex Card. The Card will be declined at any retail merchant without IIAS in place. Although the vast majority of retail card swipes are already auto-adjudicating with IIAS (meaning participants do not have to submit supporting documentation to ProBenefits), as of July 1st every retail Flex Card transaction should auto-adjudicate. This is good news, because increased auto-adjudication translates to fewer reimbursement claims for participants and reduced "pay and chase" for employers.
As of 7/1/09, over 4,000 national, regional, and local merchants will be utilizing IIAS. For an updated IIAS list, visit: www.ProBenefits.com/Debit/IIAS.html.
PLEASE NOTE: Flex Card use at medical offices, if allowed by your plan, will not be affected by this deadline. Card use at medical offices may still require documentation.
If you have any questions about the Flex Card, please contact us.
June 6, 2009 - New Flex Plan News Available
Major Topics:
- New Health Care Reform Could Impact Employer Plans
- Flex Card Update: New IIAS Deadline For July 1st
- New CHIP Special Enrollment Rights for Health Plans
- ERISA Update: Form 5500 Reporting Reminder
May 22, 2009 - FSAs and HRAs under review? Senate Finance Committee Needs to Hear From You
On May 20, 2009, the Senate Finance Committee released its options for financing health care reform. Included in the proposals for discussion are a number of options relating to employer-provided health care, including FSAs and HRAs.
- One proposal would eliminate entirely the exclusion for FSA and HRA contributions.
- Another proposal under consideration would repeal the exclusion for reimbursement of over-the-counter (OTC) items.
You can read the entire document here.
ProBenefits President, Gary Knight, has already provided feedback to the Senate Finance Committee and the Senators from North Carolina. You can read ProBenefits' response here.
ProBenefits is a member of The Employer's Council on Flexible Compensation (ECFC). The ECFC is a non-profit organization dedicated to the maintenance and expansion of private employee benefit programs on a tax-advantaged basis.
The ECFC has provided its members a sample template that can be used by Employers who share the same desire to preserve and defend the tax-advantaged programs currently available to working families through employer plan sponsors. If you would like to use this template, please click here. Additionally, we have provided a listing of all the members of the Senate Finance Committee, along with their contact information. Click here for this listing. We also highly encourage people to contact their own Congressional Representatives.
April 3, 2009 - ProBenefits Attorney Cogdill Admitted to U.S. Supreme Court Bar
On Monday, ProBenefits attorney Jason Cogdill was admitted to the Bar of the United States Supreme Court. Jason was sworn in by Chief Justice John Roberts during a session of the Court in Washington, DC.
Although the honor is largely ceremonial, attorneys must be admitted in order to appear in a matter before the Supreme Court. Membership allows attorneys access to the Supreme Court Building to attend oral arguments in the Court and to use the Supreme Court Library.
In addition to membership in the Supreme Court Bar, Jason is admitted to practice before the North Carolina Supreme Court, Federal District Courts of North Carolina, and the Fourth Circuit Court of Appeals. Jason is a 2001 graduate of Wake Forest University School of Law.
Jason has been with ProBenefits since 2004 and handles benefits compliance issues for all welfare benefit plans. In addition to his work for clients of ProBenefits, Jason maintains an active ERISA practice assisting employers and benefit advisors with compliance issues. If you would like to contact Jason regarding legal assistance on benefits or ERISA issues, you may do so at (336) 714-8012 or Jason@ProBenefits.com.
March 13, 2009 - HRA Plans: Update on MSP Reporting Requirements - CMS Announces Delay Until 2010
New mandatory Medicare reporting requirements ("MSP Reporting Rules") for third-party administrators and group health insurers went into effect on January 1, 2009. These rules require quarterly reporting for all group health plans to verify health coverage of individuals and ensure compliance with the Medicare Secondary Payer rules. It had been our hope and anticipation that HRA plans would be exempt from these requirements (as Health FSAs are), but it has been confirmed that HRAs are not exempt and must comply with the requirements. The GOOD NEWS and current update is that it was announced by CMS (Center for Medicare and Medicaid Services) last week that the reporting requirements for HRA plans will be delayed until 4th quarter 2010 to allow employers additional time to gather the necessary information to report on HRA coverage. Prior to this announcement, the initial reporting deadline would have been 10/1/09.
This is certainly good news for employers and reporting entities, since reporting by 10/1/09 would have required time and effort this year in data collection (including names and SSN data of all covered spouses and dependents covered by HRA plans). However, the news is not quite as good as we had hoped, because we and members of our industry group believed there was a fighting chance that the reporting rules would be overturned completely for HRAs. CMS reiterated that HRAs are covered by the new rules and will have to report by October 1, 2010. CMS will provide further instructions on HRA reporting at a later date.
Under the MSP Reporting Rules, data must be reported for all "active covered individuals" of group health plans, including any individuals who may be eligible for Medicare but for whom there is other group health coverage that should pay primary to Medicare. The substance of these requirements entails that HRA plan data must be gathered for spouses and dependents of participants in addition to the participant-only data currently collected for plan administration. This requirement will create additional data collection by ProBenefits for employers sponsoring HRA plans of all types (Full HRAs, Deductible Reimbursement Plans, and MERPs) so that we can comply with the new rules.
If the rules remain in effect, ProBenefits will be contacting HRA plan sponsors during 2010 with further information and to gather the necessary data and prepare the reports in compliance with the new rules. If you have any questions, please contact us.
NOTE: While the MSP Reporting Rules apply to all "group health plans," Health FSAs are specifically exempt from the rules and do not have to report in 2009 or beyond.
March 3, 2009 - COBRA: Economic Stimulus Act Includes New COBRA Premium Subsidy
The new federal stimulus act adopted by Congress ("American Recovery and Reinvestment Act") includes a COBRA provision mandating a 65 percent government subsidy to individuals who experienced involuntary terminations on or after September 1, 2008 (and before January 1, 2010). The subsidy is intended to assist these individuals with COBRA premiums for up to 9 months of coverage. With the subsidy, eligible individuals who elect COBRA (either elected since 9/1 or elect retroactively after a new notice of eligibility) will pay only 35% of the applicable COBRA premium. The remaining 65% will be paid by the employer and then credited to the employer by the IRS as a payroll tax credit. The COBRA subsidy provisions apply to all COBRA-eligible coverage (group health, group dental, group vision, HRA plans). The subsidy does NOT apply to Health FSAs.
There is a special 60-day COBRA election window during which anyone who has experienced an involuntary termination since 9/1/08 may elect coverage up to the amount they carried at the time of the termination. Notice of the availability of the subsidy should be provided to individuals who elected COBRA and are currently paying COBRA premiums as well as those who previously declined COBRA coverage after involuntarily terminations 9/1 or later. For those who have declined COBRA coverage but choose now to elect the coverage, coverage will begin 3/1/09 and is not retroactive to the date of the COBRA qualifying event.
Employers should start soon identifying individuals who will receive notice of the subsidy and preparing the substance of those notices. The DOL will make a model notice available by March 17. Notices must be given to eligible individuals no later than April 18 (60 days after date of statute).
The DOL has added a special website with detailed information on the COBRA subsidy, including a Q&A section as well as instructions on how employers should file to claim payroll tax credits for subsidy payments. The website is located at: http://www.dol.gov/ebsa/COBRA.html.
STATE CONTINUATION: As written, the premium subsidy does apply to state continuation laws (like North Carolina) which are designed to mirror COBRA coverage for groups under 20 employees. While most individual states have not released any information regarding compliance with the state continuation elements of the subsidy, it is expected that the notice requirements and related rules will be identical. (It is anticipated that many states will not make available model notices for state continuation premium subsidies, so employers will need to create their own notices).
If you have any questions about the new subsidy rules, feel free to contact ProBenefits attorney Jason Cogdill. Your company's COBRA administrator and/or benefits advisor should have more information as well.
March 3, 2009 - HIPAA: Economic Stimulus Act Broadens Privacy & Security Rules
Although most of the attention in the benefits world has been captured by the new COBRA premium subsidy rules in the new federal economic stimulus act (the American Recovery and Reinvestment Act of 2009), the Act also includes important new HIPAA provisions that expand and broaden HIPAA's privacy and security provisions. The new provisions (1) extend certain privacy and security obligations directly to business associates of group health plans, (2) create new notification requirements for breaches of unsecured PHI, (3) mandate additional disclosure requirements for electronic health records, and (4) strengthen enforcement and penalties for violations of the privacy and security rules.
Most of the new provisions become effective on February 17, 2010.
Highlights of the new HIPAA provisions:
- The Act makes a number of the privacy and security standards (as well as the civil and criminal penalties for violating those standards) applicable to business associates in the same way they apply to covered entities (including health plans).
- The Act adds new notification requirements, including that business associates that discover a breach of unsecured PHI must notify covered entities, and covered entities that experience a breach must notify affected individuals (without unreasonable delay, generally no later than 60 days after discovery). Notice must also be given to HHS, and in certain circumstances, to prominent media outlets. There is a new notification requirement applicable to vendors of personal health records and others to notify individuals and the Federal Trade Commission (which, in turn, would notify HHS) in the event of a breach. The FTC is directed to issue applicable regulations.
- The Act adds new accounting standards for PHI disclosures made by a covered entity from an Electronic Health Record. An individual would have a right to receive an accounting of PHI disclosures made through an EHR by a covered entity or its business associate for treatment, payment, and health care operations during the previous three years. Note: this requirement does not take effect until January 1, 2014 for covered entities that currently have EHRs, and the later of January 1, 2011 or the date the EHR is acquired for covered entities yet to acquire EHRs.
- The Act clarifies that business associate contracts are required when covered entities enter into a relationship with health information exchange organizations for purposes of exchanging electronic health information. This requirement is already effective and is simply a clarification.
- The Act provides guidance on the "Minimum Necessary" standard. HHS has been directed to issue guidance by August 17, 2010 on what constitutes the "minimum necessary" in connection with the use, disclosure, or request of PHI. Until that guidance is issued, the Act provides that covered entities and business associates should, to the extent practicable, limit the use, disclosure, or request of PHI to a limited data set or, if needed, to the minimum necessary to accomplish the intended purpose.
- The Act significantly increases civil monetary penalties for violations of the privacy and security standards (e.g., from $100 per violation to $1,000 or more per violation) and clarifies that criminal penalties can apply to employees who wrongfully obtain or disclose PHI maintained by a covered entity. In addition, state attorneys general are authorized to bring civil actions in federal district courts against individuals who violate privacy and security standards. These changes took effect immediately upon the law's enactment. The Act also requires HHS to conduct periodic audits to ensure that covered entities and business associates are complying with the privacy and security rules.
Further details on the new HIPAA provisions are available on the website for the federal Department of Health and Human Services (www.hhs.gov).
If you have any questions about the new subsidy rules, feel free to contact ProBenefits attorney Jason Cogdill.
January 8, 2009 - Flex Card IIAS Update: Deadline Extended for Drug Stores and Pharmacies
IRS Notice 2007-2, originally scheduled to take effect 1/1/09, imposed rules regarding use of Flex Cards at stores with merchant category codes for Drug Stores or Pharmacies. Under these rules, as of 1/1/09 these locations could not accept Flex Cards unless (1) the store utilized an Inventory Information Approval System ("IIAS") meeting IRS requirements, or (2) 90% of the store's gross receipts during the prior year consisted of items that qualify as medical expenses under IRS Code 213(d).
Recently, the IRS issued Notice 2008-12, which extends the deadline for Drug Stores and Pharmacies to meet the requirements Notice 2007-2. Now, Drug Stores and Pharmacies have an additional six months (through June 30th) to implement IIAS to be able to accept the cards. The vast majority of retail card swipes are already being auto-adjudicated with IIAS, but as of July 1st every retail Flex Card transaction should auto-adjudicate. This is good news, because increased auto-adjudication translates to fewer paper claims for participants and reduced "pay and chase" for employers.
As we have previously reported, all of the collective changes in the law and card technology since 2006 have made the Flex Card more efficient and effective than ever for plans and participants. IIAS continues to include additional retail locations where eligible expenses (including prescriptions and over-the-counter items) can be auto-adjudicated. When a participant swipes the Flex Card at a participating merchant, the IIAS system automatically verifies eligible items purchased, and no further documentation is needed from the participant. As of 1/1/09, over 1,000 national, regional, and local merchants are utilizing the IIAS system. For a complete listing of merchants with the IIAS: www.ProBenefits.com/Debit/IIAS.html. Note: cards used at medical offices may still require documentation.