For employers and other sponsors of group health plans, important deadlines are right around the corner.
MEDICARE PART D: Creditable Coverage Notice to the Centers for Medicare & Medicaid Services (CMS)
If an employer group health plan provides prescription drug coverage to anyone who is enrolled in Medicare, the employer must notify CMS as to whether the prescription drug coverage is "creditable" or "non-creditable." The notification is due within 60 days after the end of the plan year—by March 1, 2017, for calendar-year plans.
- The rule applies if any person covered by the plan is enrolled in Medicare Part A or Medicare Part B, and lives within the service area of a Medicare Part D plan.
- It does not matter whether the person is enrolled in Medicare on the basis of age or on the basis of disability.
- Most individuals are automatically enrolled in Medicare Part A (which is free) on or near their 65th birthday.
- Most employer group health plans cover at least one person who is age 65 or at least one person who is disabled and therefore will need to notify CMS.
Notification to CMS is given electronically. Click here to be taken to the starting point.
HIPAA: Breach Notice to the Secretary of Health and Human Services (HHS)
Virtually all employer group health plans are subject to HIPAA's rules requiring that various people be notified when there is a breach of unsecured protected health information (PHI). Although employers are understandably most concerned with the immediate need to notify the affected individuals, employers should not lose sight of the need to notify HHS on an annual basis. Specifically, for breaches of unsecured PHI involving fewer than 500 individuals, employers are required to notify HHS no later than 60 days after the end of the calendar year—by March 1, 2017, for calendar-year plans.
Notification to HHS is given electronically. Click here to be taken to the starting point.
AFFORDABLE CARE ACT: Large Employer Reporting
A large employer must send an individual report (Form 1095-C) to each employee who was full-time for at least one month in 2016.
- The deadline for providing this report is March 2, 2017.
The employer must also file the individual reports, together with a transmittal report (Form 1094-C), with the IRS. Employers who issue 250 or more individual reports must file electronically. These deadlines have not been extended and are much earlier than they were last year!
- The deadline for paper filings is February 28, 2017.
- The deadline for electronic filings is March 31, 2017.
A large employer must comply with these reporting obligations regardless of whether it offered health coverage or whether the coverage was fully-insured or self-funded.
If a large employer is also subject to minimum essential coverage reporting (see below), all of the information should be combined on the Form 1094-C.
AFFORDABLE CARE ACT: Minimum Essential Coverage Reporting
Any entity that provided minimum essential coverage to any individual in 2015 must send an individual report (Form 1095-B) to each person who was covered for at least one month in 2015.
- The deadline for providing this report is March 2, 2017.
The entity must also file the individual reports, together with a transmittal report (Form 1094-B), with the IRS. Entities that issue 250 or more individual reports must file electronically. These deadlines have not been extended and are much earlier than they were last year!
- The deadline for paper filings is February 28, 2017.
- The deadline for electronic filings is March 31, 2017.
An employer that offered self-funded coverage must comply with these reporting obligations whether it is "large" or "small." (However, exceptions may apply to employers whose self-funded coverage was through a multiemployer or multiple-employer welfare arrangement.)
QUESTIONS?
If you have any questions about this alert, please contact the authors or any member of Venable's Employee Benefits and Executive Compensation Practice Group.