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Pitfalls to Avoid When Negotiating Service Provider Agreements

"[1] Scope of services to be provided ... [2] Compensation and fee disclosures ... [3] Limitation of liability and indemnification applicable to both parties ... [4] Termination provision."

HIPAA Privacy and Security Audits: OCR Phase 2

"Covered entities and business associates will have approximately 10 days to respond to the audit request. OCR will issue two separate document requests via email: one for policies and procedures (and related documentation), and another for a list of business associates. Auditees must submit requested documentation to OCR's online portal[.]"

Soliciting Tax Identification Numbers for Section 6055 Reporting

"The first step of the TIN solicitation process is the initial request for an individual's TIN when the employer receives a substantially complete application for new coverage or to add an individual to existing coverage. Therefore, receipt of an employee's application would be considered the initial solicitation.... If the TIN is not initially received, then a second solicitation must be made no later than 75 days after the initial solicitation.... If the TIN is not received from the second solicitation then a third solicitation must be made by December 31 of the year following the initial solicitation."

Opt-Out Payment Arrangements and Employer Impact

"The proposed regulations clarify that if an individual declines to enroll in employer-sponsored coverage for a plan year and does not have the opportunity to enroll in coverage for one or more succeeding plan years, the individual is treated as ineligible for those succeeding years. Subsequently, this ineligibility for the plan could render that employee eligible for premium tax credits. Said another way, if employees are not given an opportunity to enroll at least annually, they are not considered eligible for the plan which could cause ALEs to be liable for Section 4980H penalties."

Recent Settlement Highlights the Need for HIPAA Business Associate Agreements

"If you are a health plan sponsor ... [p]ay particular attention to vendors who may have access to PHI ... e.g.: [1] Document disposal services if some of the documents contain PHI; [2] Providers of cloud and other off-site data storage facilities; [3] Technicians that may have access to PHI while troubleshooting or fixing computer software.... [An] employer with a fully insured health plan may still have business associates acting on behalf of a plan if: [1] It uses a broker that obtains PHI in order to quote coverage. [2] It has a Health FSA. [3] It has an HRA. [4] It has certain types of wellness or employee assistance programs."

ADA, GINA and Employer Sponsored Wellness Programs

"Prior to the publication of the new final rule, the EEOC took the view that an employer could not offer any inducement to an employee for providing family medical history.... The final rule ... states that an employer may, in certain circumstances, offer an employee limited inducements for the employee's spouse to provide information about the spouse's manifestation of disease or disorder ... However, this exception does not extend to genetic information about a spouse or to information about manifestation of diseases or disorders in, or genetic information about, an employee's children."

12 Counting Methods Employers Must Know When Sponsoring a Health Plan (PDF)

"Employee counts are used to determine what laws, rules, fees, and penalties apply to a health plan and/or the employer sponsor. But the methods for counting employees are as varied as the laws that affect them.... [This article provides] a synopsis of 12 counting methods that employers must utilize to properly administer their health plans ... [including a summary of] these counting methods in a convenient, easy-to-follow chart."

IRS Issues VCP Submission Kit for Failure to Adopt Pre-Approved Plans

"The latest submission kit is intended to assist employers who sponsor pre-approved defined contribution plans (such as master and prototype 401(k) plans), but who failed to adopt a new plan document reflecting changes required by the Pension Protection Act (PPA) by April 30, 2016."

Expiration of Shared Responsibility Transition Relief

"In its final rule on employer shared responsibility under the ACA, the IRS granted several temporary exceptions to the requirements of the rule ... In general, those exceptions expired at the beginning of 2016, or will expire sometime during the 2016 calendar year. Employers should determine which, if any, of the transition rules they used and take action to comply or prepare to comply with the strict terms of the final rule going forward."

Health FSAs and COBRA Continuation

"[Notice 2015-87] states that the carryover amount must be included in determining the amount of the benefit that a qualified beneficiary is entitled to receive.... The Notice clarifies that this does not include any unused carry-over amounts carried over from the previous plan year.... [H]ealth FSAs must allow carryovers by similarly situated COBRA beneficiaries, on the same basis as non-COBRA beneficiaries. However, the FSA is not required to allow a COBRA beneficiary to elect additional salary reduction amounts for the carryover period, or to have access to any employer contributions to the health FSA made during the carryover period."