- Posted by Jessica Waltman
- On December 13, 2019
Over the course of the year ahead, be mindful of these compliance deadlines that could impact your group health plan. If you have any questions about if a specific requirement or deadline applies to your company, please contact your Employee Benefits Consultant or Account Executive.
Date-Specific Deadlines for Employer-Sponsored Health Plans
January 31, 2020
Form W-2 is due to employees. All employers who file 250 or more Forms W-2 with the Internal Revenue Service (IRS) must report the cost of any group health insurance coverage they provide to any employee in Box 12 of the employee’s Form W-2. Employers who file less than 250 Forms W-2 in a calendar year (those not subject to the electronic filing requirements) may report an employee’s health coverage cost information in Box 12 voluntarily.
February 28, 2020
Paper copies of Forms 1094-B, 1095-B, 1094-C, and 1095-C are due to the IRS. Applicable large employers (ALEs), self-funded plan sponsors, and health insurance issuers are required to report this health coverage information to the IRS annually. However, only employers and issuers who issue less than 250 forms in the calendar year may submit using paper filings.
March 1, 2020
Applicable large employers, self-funded health plans, and health insurance carriers must send health coverage information statements, known as Forms 1095-B and 1095-C, to employees and covered individuals.
March 31, 2020
All ALEs and self-funded employers that provide coverage to New Jersey resident employees must send copies of Forms 1094-B, 1095-B, 1094-C and 1095-C to the State of New Jersey using the Division of Revenue and Enterprise Services’ (DORES) MFT SecureTransport service. This requirement, intended to help enforce the state’s health coverage mandate, applies to New Jersey-based corporations and companies located elsewhere.
April 2, 2020
Electronic submissions of health coverage information Forms 1094-B, 1095-B, 1094-C, and 1095-C are due to the IRS. Any employer or issuer who files more than 250 information returns during the calendar year must file their forms with the IRS electronically. Employers and issuers filing fewer forms can voluntarily submit them electronically.
June 30, 2020
All ALEs and self-funded employers that provide coverage to at least one employee who was a District of Columbia (DC) resident in 2019 must send copies of Forms 1094-B, 1095-B, 1094-C, and 1095-C to the DC Office of Tax and Revenue (OTR) to help enforce the District’s individual mandate. This requirement applies both to DC-based corporations and companies located elsewhere.
July 31, 2020
The 2019 PCORI (Patient-Centered Outcomes Research Institute) fee is due for sponsors of applicable self-insured health plans. These plans must annually report and pay the fee to the IRS via the submission of Form 720, Quarterly Federal Excise Tax Return.
Before October 15, 2020
A Medicare creditable coverage notice must be sent to all Medicare-eligible active employees, dependents, COBRA beneficiaries, and retirees if an employer offers them prescription drug coverage. Since it is tough to know the Medicare-eligibility status of all dependents, a best practice is to give all eligible employees, COBRA beneficiaries, and plan-eligible retirees a notice. This notice must specify if each employer plan option includes “creditable coverage,” meaning that it will cover, on average, as much as the standard Medicare Part D prescription drug plan.
When Hiring an Employee
All employers subject to the Fair Labor Standards Act (FLSA) must provide a Health Insurance Marketplace Coverage Options notice to all new hires, not just those that will be eligible for group coverage within 14 days of hire. The document must contain information about the health insurance marketplaces and their coverage options in the individual market, in addition to providing information about any group health insurance
During Open Enrollment (or when a new employee joins the plan):
All employer plans should distribute the following documents:
- Summary of Benefits and Coverage (SBC) for all plan options and the Uniform Glossary (Note: for all new plans that begin on January 1, 2021, the SBC distributed during the 2020 open enrollment period will need to use an updated federal template)
- Women’s Health and Cancer Rights Notice
- HIPAA Special Enrollment Rights Notice
Employer plans should distribute the following documents if circumstances apply:
- Grandfathered Plan Notice – Necessary if a business offers any coverage option that has “grandfathered status” according to the Affordable Care Act (ACA).
- Children’s Health Insurance Program Premium Assistance (CHIPRA) Notice – This notice needs to go to any employees who live in a state that offers premium assistance.
- Wellness Program Disclosures — If a group health benefits package includes a wellness program discussed in open enrollment materials, two different notice requirements could apply.
- HIPAA Privacy Notice for Self-Funded Plans – If an employer operates a self-funded health plan (including health reimbursement arrangements or health flexible spending arrangements).
- Medicare Credible Coverage Notice – If a new employee or their dependent is Medicare-eligible, they should get this notice when they first enroll.
Within 14 Days of Notification of Qualifying Event
Employers subject to COBRA must give a qualified plan participant a COBRA election notice within 14 days of being notified of an event that qualifies the employee or dependent for COBRA continuation coverage.
Within 60 Days of the First Day of the Plan Year (February 29, 2020, for Calendar-Year Plans)
Employers that offer prescription drug benefits to any Medicare-eligible people must file an online disclosure form with the Centers for Medicare and Medicaid Services (CMS). The disclosure indicates if the employer-plan drug benefit is “creditable,” meaning that it will cover, on average, as much as the standard Medicare Part D prescription drug plan. Since it is impossible to know if a plan participant will become Medicare-eligible during a given year, all plans that offer prescription drug benefits should complete the disclosure.
Within 90 Days of the First Day of the Plan Year (March 30, 2020, for Calendar-Year Plans)
Employers subject to COBRA must give each employee and each spouse of an employee who becomes covered under the policy a general notice describing COBRA rights.
Within 90 Days of Someone Joining the Plan
New plan participants must get a copy of the Summary Plan Description (SPD) within 90 days of being covered. If a non-grandfathered plan requires participants to designate a primary care provider, then they must get a notice of patient protections whenever the group gives out the SPD. This notice can be part of the SPD.
Last Day of the Seventh Month After the Plan Year Ends (July 31, 2020, for a calendar-year plan):
Employee benefit plans that are subject to the Employee Retirement Income Security Act (ERISA) that have more than 100 participants must jointly file Form 5500 with the IRS, the Pension Benefit Guaranty Corporation, and the Department of Labor (DOL).