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2 New Job Opportunities
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[Official Guidance]
Text of IRS Publication 5164: Test Package for Electronic Filers of ACA Information Returns (AIR), Processing Year 2025 (PDF)
18 pages, rev. Oct. 2024. "[This document] contains general and program specific testing information for use with ACA Assurance Testing System (AATS).... Software Developers must pass IRS AATS scenarios for the forms and tax year that the software package will support....
Transmitters and Issuers must pass a one-time communication test for the forms they will file." MORE >>
Internal Revenue Service [IRS]
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[Guidance Overview]
Proposed Regs Would Affect Contraceptive Coverage
"If finalized, the regulation would allow women to obtain Opill, the first-ever daily oral contraceptive pill available
over-the-counter (OTC), as well as emergency contraceptive pills and male condoms, without a prescription at in-network pharmacies without cost sharing -- but not until after January 2026.... [No-cost] coverage would only be required if the products are obtained at in-network pharmacies. If products are obtained at a store without a pharmacy or online, plans do not have to cover them." MORE >>
Henry J. Kaiser Family Foundation
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[Guidance Overview]
Gag Clause Prohibition Compliance Attestations Due by December 31 (PDF)
"The attestation is completed through the [CMS] Health Insurance Oversight System (HIOS). CMS makes available instructions for
completing the attestation, a user manual for submission, and a link to the application.... Employer-sponsors of group health plans should
reach out to their carriers or TPAs to confirm whether the attestation will be completed on the plan's behalf. If not, the employer will need to complete the attestation directly" MORE >>
VCG Consultants
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[Guidance Overview]
MHPAEA Final Rules: Plans and Issuers Must Prepare for January 1, 2025 Effective Date
"Although the Final Rules appear less burdensome than the proposed rules, they do impose significant changes to the obligations of group health plans and health insurance issuers with a short time to achieve compliance." MORE >>
Squire Patton Boggs
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[Guidance Overview]
Autumn Leaves, Pumpkin Spice Lattes, and Group Health Plan Notices
"Many of these annual notices must be provided to participants -- including employees eligible to enroll for coverage in the plan -- and beneficiaries -- including COBRA beneficiaries.... [1] Summary of Benefits and Coverage (SBC) ... [2] Summary
Annual Report (SAR) ... [3] Women's Health and Cancer Rights Act (WHCRA) Notice ... [4] Medicare Part D Notice ... [5] Children's Health Insurance Program (CHIP) Notice ... [6] HIPAA Notice of Privacy Practices." MORE >>
Spencer Fane
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[Guidance Overview]
ACA Reporting Requirements in 2025
"ALEs must furnish the 2024 Forms 1095-C to
employees no later than March 3, 2025. ALEs must file the Form 1094-C, as well as copies of the Forms 1095-C, with the IRS electronically no later than March 31, 2025. Non-ALEs sponsoring a
self-insured plan (including a level funded plan) face the same deadlines for the Forms 1094-B and 1095-B." MORE >>
Newfront
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[Guidance Overview]
Substantial Increase to Medicare Prescription Drug Benefits in 2025: What You Need to Know
"Starting January 1, 2025 all Medicare prescription drug plans (Part D Plans) must under federal law provide a cap of $2,000 on the out-of-pocket prescription drugs costs paid by the insured participant and the Part D Plan. The $2,000 cap applies to both standalone Medicare
prescription drug plans and Medicare Advantage plans with prescription drug coverage." MORE >>
Pullman & Comley
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[Guidance Overview]
New York Announces 2025 Paid Family Leave Contribution Rate, Maximum Weekly Benefits
"The contribution rate for 2025 will be 0.388% of an employee's gross wages per pay period, for a maximum annual contribution of $354.53 ... an increase from the 0.373% rate in 2024.... [T]he maximum weekly benefit amount available to individuals has been changed to
$1,177.32 ... an increase from the 2024 benefit of $1,151.16 per week." MORE >>
Jackson Lewis P.C.
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[Guidance Overview]
New and Improved California Leave Provisions for 2025
"There are expanded unpaid leave protections for victims of domestic violence, sexual assault, stalking, or qualifying acts of violence, as well as for employees summoned to jury duty or responding to a subpoena or court order to testify under Fair Employment and Housing Act
(FEHA). The changes go into effect on January 1, 2025." MORE >>
Seyfarth
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ASPE Issue Brief: Many Medicare Part D Enrollees Reached the Out-of-Pocket Limit by June in 2024 (PDF)
"Nearly 1.5 million Part D enrollees hit the cap (about $3,500) by June 30, 2024, and had no additional cost-sharing on prescription drugs for the year.... In 2025, the IRA sets a lower, uniform cap at $2,000, which is likely to result in further savings for Medicare
enrollees. About 4.6 million Medicare Part D enrollees reached this threshold by June 30, 2024." MORE >>
Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS]
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Observations on the Employer Stop-Loss Market: 2024 Survey
"Over 70% of specific stop-loss premium in 2023 in [this] survey can be attributed to policies with deductibles between $100,000 and $500,000 ... In 2023, nearly half of respondents experienced loss ratios on their specific stop-loss business that were higher than
target." MORE >>
Milliman
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A Pivotal Moment in the Fight for Behavioral Health Equity
"[1] Basics of health insurance and ERISA.... [2] Inadequate access to behavioral health services and reimbursement.... [3] A push for mental health parity.... [4] Key changes in the Parity Act regulations.... [5] Case highlights: fighting for behavioral
health rights.... [6] How providers and patients can combat improper denials of benefits." MORE >>
Zuckerman Spaeder LLP
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Benefits in General |
[Official Guidance]
Draft of Instructions for IRS Form 8868: Application for Extension of Time to File an Exempt Organization Return or Excise Taxes Related to Employee Benefit Plans (PDF)
Oct. 21, 2024 "What's New: Form 8868 was revised to include the extension of time to file Form 990-T, Exempt Organization Business Income Tax Return (and proxy tax under section 6033(e)) used for governmental entities. A properly completed Form 8868
submitted by the due date for Form 990-T will give you an automatic 6-month extension after the normal due date for Form 990-T. Governmental entities filing Form 990-T must use Return Code 15" MORE >>
Internal Revenue Service [IRS]
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Employee Benefits Jobs
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Press Releases |
Top Performers Honored with 2024 Martin Rosenberg Academic Achievement Award at ASPPA Annual
ASPPA [American Society of Pension Professionals & Actuaries]
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Mayo Announced as Winner of Thomas J. Finnegan III Educator’s Award at ASPPA Annual
ASPPA [American Society of Pension Professionals & Actuaries]
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Bridgeway Benefit Technologies Forms Strategic Partnership with The Berwyn Group for Death Audit and Locate Solutions
Berwyn Group
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Pentegra Welcomes M. Palmer Whitney as Vice President, Head of
Client Relations
Pentegra
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2024 PenChecks Trust ASPPA Scholarship Winners Announced
ASPPA [American Society of Pension Professionals & Actuaries]
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Webcasts and Conferences (Health & Welfare Plans) |
Statutory Paid Leaves: What You Need To Know For 2025
November 20, 2024 WEBINAR
Disability Management Employer Coalition [DMEC]
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Last Issue's Most Popular Items |
Text of IRS Rev. Proc. 2024-40: Inflation-Adjusted Amounts for 2025 (PDF)
Internal Revenue Service [IRS]
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Text of IRS Notice 2024-75: Preventive Care for Purposes of Qualifying as a High Deductible Health Plan Under Section 223 (PDF)
Internal Revenue Service [IRS]
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Text of Agency FAQs About ACA and Women's Health and Cancer Rights Act Implementation, Part 68 (PDF)
U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department
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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.
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