On August 23, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable Care Act (ACA) affordability threshold will be 8.39% for plan years beginning in 2024, a substantial decrease from the 9.12% affordability threshold set for plan year 2023. This marks the largest change yet in the affordability thresholds year-over-year. The affordability threshold is used to determine whether employer-sponsored health coverage is affordable for purposes of the ACA’s employer-shared responsibility provisions.

Continue Reading Planning for Open Enrollment? Note the ACA Affordability Threshold Drop

We recognize that many companies sponsor ERISA welfare benefit plans and will soon be undergoing their open enrollment process and issuing related participant communications. To assist with that process, we have prepared an Automatic Participant Disclosures Checklist for use during open enrollment and throughout the plan year. Note that some of these disclosures may be

On April 28, 2023, the IRS Office of Chief Counsel issued Chief Counsel Advice Memorandum 202317020 (CCA Memo), with an important reminder to employers who provide health and dependent care flexible spending arrangements (FSAs) under an Internal Revenue Code (Code) Section 125 cafeteria plan: a failure to adequately substantiate FSA expenses before reimbursement may result in the loss of the tax-free status of all benefits provided under the Code Section 125 cafeteria plan.  

Continue Reading Flexible Spending Accounts: Require Substantiation or Risk Disqualification

Late last week, the Internal Revenue Service (IRS) issued guidance on Section 603 of the SECURE 2.0 Act with respect to catch-up contributions. The guidance includes a two-year administrative transition period – until 2026 – to implement the Roth catch-up contribution provisions under SECURE 2.0 and is in response to employer coalitions and industry groups who had voiced concerns about being able to timely implement those provisions.

Continue Reading Amid Concerns, IRS Delays Required Roth Catch-Ups Until 2026 to Allow For Plan Compliance

In a win for self-funded (i.e., self-insured) health plans subject to the Employee Retirement Income Security Act of 1974, as amended (ERISA), the Tenth Circuit recently ruled that ERISA preempts provisions of an Oklahoma law regulating pharmacy benefit managers (PBMs) and pharmacy networks. The states in the Tenth Circuit are: Colorado, Kansas, New Mexico, Oklahoma, Utah, and Wyoming.

Continue Reading Tenth Circuit Rules ERISA Preempts Oklahoma PBM-Reform Law

On July 25, the Department of Labor, Department of the Treasury, and Department of Health and Human Services (the Departments) released new Proposed Rules (Proposed Rules) that clarify certain requirements imposed by the Mental Health Parity and Addiction Equity Act (MHPAEA). In addition to the new Proposed Rules, the Departments issued their annual MHPAEA report to Congress (Report) to detail recent enforcement efforts.

Continue Reading New Proposed Mental Health Parity Rules Amid Report of Widespread Failure

On January 30, President Biden announced his intention to end the COVID-19 National Emergency (NE) and Public Health Emergency (PHE) effective May 11, 2023. Both emergency declarations resulted in various forms of relief for employer-sponsored benefit plans, and both have been extended several times since their inception nearly three years ago. While their impact on federal law differs, employee benefit plan sponsors and administrators should take note of the ending emergencies and their associated relief. Below is an overview of the impact that the end of this relief will have on employer-sponsored benefit plans.

Continue Reading Tolling No More: Preparing for the End of COVID-19 Emergency Declarations

I recently provided insight on the January 26 ruling by the U.S. Court of Appeals, Ninth Circuit holding that although United Behavioral Health violated its fiduciary responsibility as outlined in the Employee Retirement Income Security Act (ERISA) by incorrectly denying behavioral health claims, the patients who were denied coverage had no right to appeal. This case is being closely watched as it could set a precedent for the behavioral health industry and future access to mental health and addiction treatment.

Continue Reading Latest Ruling in Wit v. United Behavioral Health Case

As widely reported, the president recently signed into law the Consolidated Appropriations Act of 2023 (CAA 2023), a $1.7 trillion omnibus spending bill, which contains significant provisions affecting employer-sponsored retirement and welfare benefit plans. The provisions impacting retirement plans are included in a separate section of CAA 2023 referred to as the SECURE 2.0 Act of 2022 (SECURE 2.0 or the Act), which in many ways builds upon the first SECURE Act passed in 2019 (SECURE 1.0). The following items highlight what we believe are the most important changes affecting employer-sponsored retirement and welfare benefit plans and also provide practical advice for plan sponsors.

Continue Reading SECURE 2.0 + 1: Retirement Plan Changes and One Notable Health Plan Change