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… any portion of a plan’s premium, the employer must calculate how much of any MLR rebate should be considered plan assets, meaning that the rebate should be used strictly for the benefit of plan participants. Decisions about how to allocate the participants’ portion of the rebate are subject to Employee Retirement Income Security Act (ERISA)’s general standards of fiduciary conduct. Background Included in the Affordable Care Act (ACA) were new rules that required health insurance companies to disclose certain financial data. This includes the portion of medical plan premiums spent on paying claims and quality improvement initiatives and …

Quick Facts After a National Emergency was declared, the regulatory agencies jointly issued a final rule extending several deadlines applicable under the Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA) and Employee Retirement Income Security Act (ERISA). For the period beginning March 1, 2020, until 60 days after the end of the National Emergency, all group health plans, disability plans, other employee welfare benefit plans and employee pension plans must disregard the time period known as the “Outbreak Period” when administering plans with respect to the deadlines covered by the rule. IRS guidance in Notice …

Quick Facts Washington State recently passed legislation requiring health insurance carriers and health plans to pay a quarterly assessment to assist medical providers with managing patients’ mental health needs. Health insurance carriers will pay on behalf of fully insured plans, but self-funded plans may need to pay the fee themselves. Fees will be reported and paid online quarterly. The fees are not preempted by Employee Retirement Income Security Act (ERISA). Background The state of Washington has passed legislation requiring health insurance carriers and employers that sponsor self-funded health plans to pay a quarterly assessment to support a state …