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Posted

I don't believe there is any advance notice requirement, even if ERISA applies, correct? Yes, any eligible expense incurred prior to the amendment date would need to be covered, but still no legal/regulatory requirement for advance notice, similar to a 204(h) notice in the qualified plan world?

Thanks.

Posted

Most HRAs sponsored by private sector employers are subject to ERISA.  ERISA requires advance notice of certain types of changes.  See ERISA 104(b)(1) and associated regs.

Posted

Thank you for the response. However, where, if at all, do you find a requirement for advance notice of an amendment reducing future benefits in an HRA? For example, calendar year HRA provides that once a participant pays $1,000 out of pocket, the HRA kicks in. If the employer decides that they want to change this to $1,500 effective October 1, 2017, is advance notice required - and if so, what is the specific timeframe?

In the qualified plan world, we have ERISA 204(h). What, if any, is the corresponding citation for an advance notice requirement for an HRA?

Thanks!

Posted

Again, look at ERISA 104(b) and associated regs--that's the citation.  It states when the notice has to be given, and under what circumstances.  

Posted

Advanced notice  on the group health plan world is only required if the plan has a Summary Benefits and Coverage (SBC) and the change impacts the content of the SBC. Standalone HRAs are generally prohibited under ACA so I assume your HRA is integrated with the employer's major medical plan. If that is the case and the major medical plan's SBC includes HRA reimbursement information you likely will have to give 60 days advance notice of the change. If the change does not impact the content of the SBC, then to the extent the HRA is subject to ERISA (likely) then the SMM rules will apply in which case notice is required within 60 days after the adoption (not the effective date) of the change.  Hope that helps.

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