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Category: Compliance News
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IRS Increases PCORI Fee Rate | Pennsylvania Benefits Team
The Internal Revenue Service (IRS) has issued Notice 2025-61, announcing a significant increase to the Patient-Centered Outcomes Research Institute (PCORI) fee amount. Employers with self-insured health plans and health insurance issuers must take note of the new rate and upcoming compliance deadlines. What is the New PCORI Fee Amount? The PCORI fee is increasing to…
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What Brokers Should Be Doing Now to Get Clients ACA-Ready | PA Benefits Consultants
How to position yourself as a trusted ACA compliance advisor For brokers and benefits advisors, Q4 planning doesn’t start in October. It starts now. September marks a critical moment in the annual ACA compliance cycle, when employers begin thinking about year-end strategies, benefits renewals, and how to avoid last-minute reporting panic. That makes now the perfect…
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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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ACA Reporting Deadlines for 2025: What You Need to Know | PA Employee Benefits Agency
For employers subject to the Affordable Care Act (ACA), staying compliant with reporting requirements is non-negotiable. With 2025 due dates just around the corner, now is the time to prepare for distributing Forms 1095-C to employees and filing with the IRS. These forms provide essential information about health coverage offered to employees and are critical…
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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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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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PCORI fees are due by Monday, August 1, 2022 | PA Employee Benefits Advisors
By way of background, the Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) to study clinical effectiveness and health outcomes. To finance the Institute’s work, a small annual fee—commonly called the PCORI fee—is charged on group health plans. Grandfathered health plans are not exempt. Most employers do not have to take any…
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Transparency in Coverage | Pennsylvania Benefits Consultants
Health plan price transparency helps consumers know the cost of a covered item or service before receiving care. Beginning July 1, 2022, most group health plans and issuers of group or individual health insurance will begin posting pricing information for covered items and services. This pricing information can be used by third parties, such as…
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Employer Medicare Part D Notices Are Due Before October 15 | PA Benefit Advisors
Are you an employer that offers or provides group health coverage to your workers? Does your health plan cover outpatient prescription drugs—either as a medical claim or through a card system? If so, be sure to distribute your plan’s Medicare Part D notice before October 15. Purpose Medicare began offering “Part D” plans—optional prescription drug…
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July 2017 Compliance News | PA Benefit Advisors
Health Reform Update After many months of working on possibly repealing and replacing the Patient Protection and Affordable Care Act (ACA), it looks like Congress might be ready to throw in the towel for the time being. A revised plan to change parts of the ACA and restructure Medicaid alienated both very conservative Republicans and…
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