This checklist may be used to help establish that a qualifying event (or mid-year election change event) has occurred that would allow a participant to change his or her election outside of the standard open enrollment period. It should be customized to fit your plan offerings prior to use.
On September 6, the IRS released Revenue Procedure 2024-35, which contains the 2025 contribution percentage to determine whether an employer-sponsored group health plan is considered affordable to an employee under the Affordable Care Act. For plan years beginning in 2025, a group health plan will be considered affordable if the employee’s contribution for self-only coverage does not exceed 9.02% of the employee’s household income.
Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before the start date of the annual enrollment period for Medicare Part D, which begins on October 15 of each year.
Under the HIPAA Privacy Rule, companies with self-funded health plans must provide a privacy notice or notify participants that one is available at least every three years and include instructions for obtaining a copy. Therefore, self-funded employers that have not distributed their privacy notice in the last three years should do so now to meet the triennial requirement.
The right healthcare plan funding strategy depends largely on your organization’s risk tolerance. If your organization tends to be conservative, you will likely prefer remaining fully insured. If you are in the middle ground, the best choice may be a level-funded or self-funded plan with a single vendor. But if you are comfortable assuming a higher level of risk, a self-funded program with multiple vendors may be the most logical choice.
Earlier this year, our experts shared insights and strategies for addressing employee benefits-related trends, compliance issues and cost-containment challenges. Now, you can watch the recorded webinars and download presentation materials on demand.
Hylant's HR Navigator offers an abundance of tools and resources that enable HR professionals to operate effectively and efficiently. One such resource: Enrollment Booklet Builder. Informing and educating employees about their benefit options is important to creating an engaging and healthy workforce. Instantly create, manage and store enrollment booklets that are customized with your colors, logos and fonts that will help outline available plans and options for employees.
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