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Category: Compliance
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Meeting the ERISA Deadline: Handling MLR Rebates | PA Employee Benefits Group
Employers with insured health plans may have received a Medical Loss Ratio (MLR) rebate from their health insurance carrier this year. Rebates were required for plans not meeting the 2024 MLR standards and had to be issued by September 30, 2025, either as premium credits or lump-sum payments. If any part of the rebate qualifies…
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Compliance Risks in Open Enrollment: 5 Mistakes and How to Avoid Them | Pennsylvania Benefits Group
Open enrollment is a hectic and critical period for employers that often brings a risk of compliance errors. These mistakes can confuse employees and cause missed benefits, while also exposing employers to legal risks. This article highlights five common compliance pitfalls to avoid during open enrollment: By proactively addressing these areas, employers can help employees…
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Form 5500 Filing Requirements: Deadlines, Penalties, and Compliance Options | PA Employee Benefits Consultants
If your company provides an employee benefit plan governed by the Employee Retirement Income Security Act (ERISA), you are likely obligated to file Form 5500. This annual report discloses key details about your organization’s benefit offerings, such as welfare benefit plans (including medical, dental, life, and disability coverage), retirement plans, fully insured plans, and self-funded…
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The Clock is Ticking: Do Not Miss the EEO-1 Report Deadline | Pennsylvania Benefits Agency
The annual EEO-1 Report, mandated by the Equal Employment Opportunity Commission (EEOC), is a cornerstone of workplace diversity and anti-discrimination efforts in the United States. This data collection provides a demographic snapshot of America’s workforce, helping to monitor for discrimination and promote equal employment opportunity. Missing the deadline can lead to serious consequences, making it…
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New Legislation Updates ACA Reporting Rules | PA Benefits Consultants
At the close of 2024, Congress passed two new pieces of legislation: the Paperwork Burden Reduction Act and the Employer Reporting Improvement Act. These laws simplify the Affordable Care Act (ACA) reporting requirements for employers and introduce new limits on the IRS’s authority to enforce “pay-or-play” penalties, among other changes. Under the ACA, applicable large…
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Gag Clause Attestation Deadline | PA Benefits Group
As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit…
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Medical Loss Ratio (MLR) Rebates: A Timely Reminder | Pennsylvania Benefits Partners
The Affordable Care Act (ACA) introduced the Medical Loss Ratio (MLR) to ensure that health insurance companies spend a significant portion of premiums on medical care and quality improvement activities rather than administrative costs and profits. When insurers fail to meet the MLR threshold, they are required to issue rebates to plan sponsors. Understanding MLR…
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PCORI Fee Filing Deadline | PA Benefits Advisors
The Patient-Centered Outcomes Research Trust Fund fee, often referred to as the PCORI fee, can be a source of confusion for employers offering health insurance plans. This article aims to simplify what the PCORI fee is, why it exists, and how it impacts your business. What is the PCORI Fee? The PCORI fee is an…
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Benefits Check-up: 6 Compliance Issues Affecting Your Clients’ Health | PA Employee Benefits Agents
A health plan is more than a product or service; it’s a relationship. All productive and healthy relationships—especially in the benefits space—rely on trust. When an employer extends trust in a broker or insurance carrier to purchase something as critical as healthcare—for people as critical as their workers and families—we’re obligated to raise all factors…
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Benefits Buzz January 2024 | Pennsylvania Benefits Agency
Health Plans Must Expand Price Comparison Tool for 2024 Beginning in 2024, group health plans and health insurance issuers must expand the internet-based price comparison tool they make available to participants, beneficiaries and enrollees so that it includes all covered items, services and drugs. The purpose of this tool is to provide consumers with real-time…
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