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Health & Welfare Plans Newsletter

December 10, 2021

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[Official Guidance]

Text of 2021 Instructions for IRS Forms 1094-C and 1095-C (PDF)

18 pages; Dec. 9, 2021. "What's New ... For 2021, Form 1095-C has been modified to add new codes 1T and 1U for individual coverage HRAs offered to the employee and spouse but not dependents.... The due date for furnishing Form 1095-C to individuals is extended from January 31, 2022, to March 2, 2022." [Also available: 2021 IRS Form 1094-C and 2021 IRS Form 1095-C]  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of 2021 Instructions for IRS Forms 1094-B and 1095-B (PDF)

7 pages; Dec. 9, 2021. "What's New ... Extension of due date for furnishing statements. The due date for furnishing Form 1095-B to individuals is extended from January 31, 2022, to March 2, 2022." [Also available: 2021 IRS Form 1094-B and 2021 IRS Form 1095-B.]  MORE >>

Internal Revenue Service [IRS]

[Official Guidance]

Text of EBSA Comment Request with OMB Submission: Renewal of Certain Health Plan Information Reporting

EBSA is requesting OMB approval for extension of certain reporting forms, and requests public comment on those extensions. Expiring May 31, 2022: [1] [ACA] Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier Disclosure; [2] [ACA] Advance Notice of Rescission; and [3] Summary of Benefits and Coverage and Uniform Glossary Required Under the [ACA]. Expiring June 30, 2022: [1] Prohibited Transaction Class Exemptions for Multiple Employer Plans and Multiple Employer Apprenticeship Plans -- PTE 1976-1, PTE 1977-10, PTE 1978-6; and [2] Notice for Health Reimbursement Arrangements Integrated with Individual Health Insurance Coverage.  MORE >>

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

[Official Guidance]

Text of 2022 Instructions for IRS Forms 1099-SA and 5498-SA: Distributions from an HSA, Archer MSA, or Medicare Advantage MSA, and HSA, Archer MSA, or Medicare Advantage MSA Information (PDF)

"File Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information, with the IRS on or before May 31, 2023, for each person for whom you maintained a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA) during 2022. You are required to file if you are the trustee or custodian of an HSA, Archer MSA, or MA MSA. A separate form is required for each type of plan. For HSA or Archer MSA contributions made between January 1, 2023, and April 18, 2023, you should obtain the participant's designation of the year for which the contributions are made."  MORE >>

Internal Revenue Service [IRS]

[Guidance Overview]

COVID-Related Benefit Mandates Continue

"As group health plan sponsors head into 2022 and contemplate a third year of COVID-19 related medical claims, many are confused about what COVID-19 related expenses are required to be covered at 100% cost-sharing and for how long."  MORE >>

Spencer Fane

[Guidance Overview]

Free At-Home COVID Tests Coming Soon But Questions Abound

"[The administration's] nine-point action plan ... [includes an] expanded requirement for group health plans and insurers to cover or reimburse at-home rapid, over-the-counter (OTC) COVID-19 tests without participant cost-sharing ... [Questions which] forthcoming guidance should answer [include] [1] May group health plans impose limitations (such as number, frequency, dollar amount caps) on coverage / reimbursement of at-home tests without participant cost-sharing? [2] Will the at-home test need to be proctored by a health professional to be eligible for coverage without participant cost-sharing? [3] Will the at-home test be fully covered at point-of-sale, or will participants need pay upfront and then submit claims for reimbursement?"  MORE >>


[Guidance Overview]

Group Health Plans Must Report Pharmacy and Health Plan Spending Though Deadline Now Extended

"[T]he Departments are exercising enforcement discretion so that the first reporting (which can include both 2020 and 2021) will not be required until December 27, 2022. Even with that extension, plans are encouraged to report as soon as they can.... [T]he interim final rules state that employers with insured plans can contract with their insurance carriers to provide this reporting.... If the carrier does not complete the reporting, then the carrier will be responsible for the non-compliance. By contrast, self-funded employers may contract with their TPAs to provide the reporting. However, if the TPA fails to adequately report, the responsibility will fall back on the plan sponsor."  MORE >>

HUB International

Doctors, Hospitals Challenge HHS Rules for Arbitrator Settlement of Surprise Billing Cases

"The lawsuit from the American Hospital Association and the American Medical Association does not seek to halt the law from going into effect in January. Instead, it seeks a change in a key provision in regulations issued in September. At issue is how arbitrators will decide the amount insurers pay toward disputed out-of-network bills." [American Medical Association v. HHS, No. 21-3231 (D.D.C. complaint filed Dec. 9, 2021)]  MORE >>

Kaiser Health News

Stakeholder Groups Urge Congress to Extend Pre-Deductible Telehealth Coverage

"The current relief permits HSA-qualifying HDHPs to cover telehealth and other remote care services before individuals have satisfied their deductible, without jeopardizing their eligibility to make or receive HSA contributions.... Unlike some other pandemic-related flexibilities provided to health plans, this relief ... is set to expire at the end of the plan year that began in 2021 (e.g., Dec. 31, 2021 for calendar-year plans), unless extended by Congress."  MORE >>


CRS 'In Focus': Build Back Better Act Provisions for Universal Comprehensive Paid Leave

"[T]he act proposes to amend the Social Security Act ... by adding Title XXII: Comprehensive Paid Leave Benefits, which would entitle eligible individuals to up to four workweeks of cash benefits in each benefit period (generally, a 12-month period). Benefits would be payable starting January 2024, and the program would be permanently authorized." [IF11994]  MORE >>

Congressional Research Service [CRS]

Benefits in General

New ERISA Decisions Diverge on Federal Civil Procedure

"Over the past several months, there has been a flurry of federal appellate opinions questioning civil procedure norms in [ERISA] benefits litigation. A pair of brand new appellate decisions have also focused on the same issue, although not necessarily in a direction that harmonizes ERISA civil procedure with the Federal Rules of Civil Procedure." [Avenoso v. Reliance Standard Life Ins. Co., No. 21-1772 (8th Cir. Nov. 30, 2021); Noga v. Fulton Financial Corp. Employee Benefit Plan, No. 19-3855 (3d Cir. Nov. 26, 2021)]  MORE >>

DeBofsky Sherman Casciari Reynolds P.C.

Employee Benefits Jobs

View job as Defined Contribution Account Manager (Part Time)
for Nova 401(k) Associates Defined Contribution Account Manager (Part Time)

Nova 401(k) Associates

Remote / Houston TX / Dallas TX / Scottsdale AZ

Press Releases

Definiti Appoints New Chief Financial Officer

Definiti LLC

Webcasts and Conferences
(Health & Welfare Plans)

No Surprises Act: New Rules and Guidance for Stakeholders, Part 1 – Diagnosing Health Care


Epstein Becker & Green

Last Issue's Most Popular Items

Why You Need to Get Your ACA Reporting Forms Right This Coming Year

HUB International

Taking Control of COVID-19 Policies: How U.S. Employers Can Move Forward While the Vaccination Mandate Ping-Pong Match Plays On


Managing Compensation and Benefits in a Competitive Labor Market

Newport Group

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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.

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