Changes Proposed for Form 5500

Federal agencies are proposing changes to improve Form 5500 Annual Return/Report. If adopted, the changes would generally apply for plan years beginning on or after Jan. 1, 2019.

View this flyer to learn what these proposed revisions are intended to do and what plans would be affected.

 

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Transitional Reinsurance Deadline Approaching

Employers must submit the 2016 Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form and schedule payment no later than Nov. 15, 2016 on Pay.gov.

In 2016, the fee is $27 per average covered life. The first installment of $21.60 per average covered life is due no later than Jan. 17, 2017, and the second installment of $5.40 per average covered life is due no later than Nov. 15, 2017. Plan sponsors can also pay the fee in full by the deadline of the first installment.

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April 2017 Edition of the SBC Template and Supporting Documents

Health plans and issuers that maintain an annual open enrollment period will be required to use the April 2017 edition of the SBC template and associated documents beginning on the first day of the first open enrollment period that begins on or after April 1, 2017, for plan years beginning on or after that date. For plans and issuers that do not use an annual open enrollment period, this SBC template and associated documents are required beginning on the first day of the first plan year that begins on or after April 1, 2017.

In addition, the Center for Consumer Information & Insurance Oversight (CCIIO) has temporarily suspended the completion of a new third coverage example for a simple fracture for the 2017 Summary of Benefits and Coverage (SBC).

Until further notice, self-funded plans and insurers should enter default values of “$0” on the Plans and Benefit template for each field for this coverage example, according to the CCIIO, which is part of the Centers for Medicare and Medicaid Services.

Self-funded plans and insurers may continue to use the Coverage Example Calculator approved for plan year 2016 to calculate data for the two other SBC coverage examples: “Having a Baby” and “Managing Diabetes.”

For more information on SBCs, follow this link.

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Regulations on Section 1557 Prohibit Discrimination

The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) published a final rule implementing Section 1557 of the ACA prohibiting “covered entities” from discriminating in the provision of a health program or activity based on race, color, national origin, sex, age or disability.

The regulations require covered entity’s anti-discrimination notice and taglines be published by October 16, 2016, and health benefit plan documents be amended when renewed on and after January 1, 2017.

Who Is a Covered Entity?

A covered entity may include doctors, hospitals, health plans and other medical providers that receive federal financial assistance from HHS. Examples of federal financial assistance include Medicaid and Medicare Parts A, C and D payments (including prescription drug subsidies).

View a flyer, Navigating Anti-Discrimination Regulations, to learn more. Or for additional reference materials, go to the HHS website.

Starmark® will send potentially affected employers (determined by SIC codes), beginning with effective dates of October 15, 2016, the Notice Regarding Section 1557 of the Affordable Care Act form. Employers who receive this form must complete it and return it to Starmark.

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ACA Reinsurance Assessment Fee – Important Filing and Payment Dates

Sponsors of self-funded health benefit plans are responsible for filing and paying the ACA Reinsurance Assessment Fee. To assist with the filing, Starmark® will calculate the average number of lives covered under the sponsor’s plan and will mail the information to the sponsor mid-October.

To file, sponsors must go to http://www.pay.gov and complete the ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form online no later than November 15, 2016. If they are making the payment in one lump sum, the payment must be remitted no later than January 17, 2017, at http://www.pay.gov; or if making the payment in two installments, they must pay the first installment by January 17, 2017, and the second installment no later than November 15, 2017, at http://www.pay.gov.

 

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Reinsurance Program Training

The Centers for Medicare and Medicaid Services has scheduled a series of free webinars to help contributing and reporting entities who are required to file the 2016 Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form.

Free training webinars will be held from 1 p.m. to 2:30 p.m. Eastern Time on the following four dates:

Module 1 2016 Reinsurance Contributions Overview Tuesday, Sept. 13, 2016
Module 2 2016 Reinsurance Contributions Counting Methods Overview Thursday, Sept. 15, 2016
Module 3 2016 Reinsurance Contributions Form Completion Tuesday, Sept. 20, 2016
Module 4 2016 Reinsurance Contributions Updating Contributions Filings Tuesday, Oct. 18, 2016

Registration will be on a first-come, first-served basis.

Log on to www.REGTAP.info for registration

For more information on the Reinsurance Assessment Fee, follow this link.

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Letters Being Sent to Employers Regarding Social Security Numbers

Starting this week, Starmark® employers with a self-funded plan design will receive letters via mail providing information on the status of dependent social security numbers (SSNs). This will help with their 2017 ACA 6055/6056 filing requirements by letting them know if we are missing SSNs for any covered dependents. The broker of record will receive a copy of their group(s) letter.

If the employer has any covered dependents in 2016 with missing SSNs, or adds a dependent later with a missing SSN they can log in to the Starmark website and update the information under Manage My Group > Dependent SSN Update. The initiative by the employer to obtain and update all missing information will help to ensure that the January 2017 report available in the Document Center will be as complete as possible.

It is the employers’ responsibility to collect the pertinent information and file the appropriate documents with the IRS for all employees. Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

View the letters below:

Social security numbers missing

Add-on information

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Filed under 6055/6056 Reporting, Healthcare reform