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QUICK FACTS COBRA provides certain individuals the right to continue health coverage under an employer sponsored plan when they experience specified events, called qualifying events (QE). When a qualified beneficiary (QB) experiences a QE due to termination of employment, COBRA requires a covered employer to offer continuation coverage unless it terminated the employee for gross misconduct. COBRA does not define gross misconduct; the term is defined by the courts. Employers should carefully weigh decisions to deny COBRA coverage due to gross misconduct and should consider consulting counsel. A spouse or dependent who loses health coverage due to divorce or legal …

… health insurance. INDIVIDUAL COVERAGE HRA Beginning January 1, 2020, employers can offer certain classes of employees an ICHRA as long as: The purchase of individual insurance is voluntary; An employer does not select or endorse any particular issuer or insurance coverage; The individual insurance does not consist solely of excepted benefits (e.g., dental or vision coverage); An employer receives no consideration in cash or other form based on an employee’s selection of individual coverage; and An employer notifies employees annually in writing (either no later than 90 days before the start of a plan year or no later …

… AHP in the large group market. The final rule responded to Executive Order 13813 (Order). Under the Order, President Trump urged the Secretary of the DOL to consider expanding the conditions that satisfy the commonality of interest requirements under existing DOL interpretations of the definition of an “employer” under the Employee Retirement Income Security Act (ERISA). On March 28, 2019, the U.S. District Court for the District of Columbia vacated the final rule’s provisions regarding who is an “employer” for purposes of who can sponsor an AHP, which left those who had established AHPs based on the final …

… employees on at least 50% of its typical business days in the prior calendar year. Employers must count full- and part-time employees – with each part-time employee counting as a fractional employee based on the number of hours he or she worked divided by the number of hours an employee must work to be considered full-time. COBRA applies to plans maintained by most private-sector and state and local governmental employers. The law does not apply to plans sponsored by the federal government or by churches and certain church-related organizations. ELIGIBILITY FOR COBRA BENEFITS A covered group …

BACKGROUND The IRS recently released Revenue Procedure 2019-25, which includes the 2020 inflation-adjusted amounts for health savings accounts (HSAs) and high deductible health plans (HDHPs). These limits include the maximum HSA contribution limit, the minimum deductible amount for HDHPs, and the maximum out-of-pocket expense limit for HDHPs. These limits vary based on whether an individual has self only or family coverage under an HDHP. The IRS limits for HSA contributions and HDHP maximum out-of-pocket limits will increase effective January 1, 2020, while the HDHP limits will increase effective for plan years beginning on or …

… s market reforms that took effect in 2014. The ACA includes key reforms that created new coverage standards for health insurance policies effective as of 2014. For example, the ACA imposes modified community rating standards and requires individual and small group policies to cover a comprehensive set of essential health benefits. Late in 2013, millions of Americans received notices informing them that their plans would be canceled because they did not comply with the ACA’s reforms – contrary to government assurances that if individuals had a plan they liked, they could keep it. Responding to pressure from consumers and Congress …

… In response, the EEOC recently removed the limits from its regulations effective January 1, 2019. Wellness program sponsors should be aware, however, that the remaining EEOC wellness rules remain intact, including certain notice requirements and that any wellness program providing incentives must be “voluntary” as defined under the EEOC rules. BACKGROUND The EEOC enforces the ADA and the Genetic Information Nondiscrimination Act (GINA), both of which affect wellness program design. The final ADA rules provided that incentives offered to an employee who answers disability-related questions or undergoes medical examinations as part of a wellness program may not exceed 30%

QUICK FACTS The U.S. Department of Labor (DOL) recently issued its annual inflation-adjusted penalty amounts for certain Employee Retirement Income Security Act (ERISA) violations. The adjusted amounts are intended to create greater incentives to comply with certain federal laws applicable to health and welfare benefit plans. Federal agencies, including the DOL, are required to make annual adjustments to the adjusted civil penalty amounts by January 15 each year. The 2019 adjustments are effective for penalties assessed after January 23, 2019 with respect to violations occurring after November 2, 2015. BACKGROUND Legislation enacted in 2015 requires federal agencies to …