Developments in Benefits
The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their employees. Many of these reforms apply to all group health plans, regardless of their method of funding. Plans that have grandfathered status under ACA, however, are not required to comply with select health care reform requirements. In addition, self-insured plans are exempt from certain ACA requirements.
A self-insured plan is a health plan where the employer assumes the financial risk of providing health care benefits to its employees. Employers may decide to self-insure their health plans for a number of reasons, such as avoiding state insurance taxes and state benefit mandates, retaining more control over plan design and controlling reserves. There may also be disadvantages associated with self-insuring, such as a greater assumption of risk and increased administrative obligations. - View the PDF
Many of ERISA’s requirements apply on a plan-by-plan basis, so it is important to know – and to clearly document – how many plans you maintain for ERISA purposes. A plan sponsor is generally free to determine the number of welfare benefit plans it maintains – there are no hard-and-fast rules for making that determination. As the plan sponsor, you should affirmatively decide how many plans you intend to maintain, and reflect this decision in your written plan document(s). For example, you may choose to use a “wrap” plan document to establish a single, “bundled” plan, through which all of your welfare benefits are provided. Alternatively, you could bundle different types of welfare benefits in different configurations (e.g., health, dental, vision, and employee assistance under one plan; short-term disability and long-term disability under another plan). Or you could provide each benefit through a separate plan. - View the PDF
On June 28, 2012, the U.S. Supreme Court issued its decision on the constitutionality of the health care reform law. The Court ruled that Congress acted within its constitutional authority when enacting the individual mandate and it upheld the law.
A major component of the health care reform law, or Affordable Care Act, is the individual mandate — a provision that will require most individuals to purchase health care coverage or pay a penalty, beginning in 2014. The legal challenge to the health care reform law focused on the individual mandate.
In its decision, the Supreme Court held that Congress had the power to enact the individual mandate. Because the Court upheld the mandate, it did not need to decide whether other provisions of the law were constitutional. Thus, the Supreme Court upheld the health care reform law. - View the PDF
As health care costs continue to rise, so has the demand for voluntary benefits. Since many employers find it increasingly difficult to provide employees with a complete benefit package, voluntary benefits have become an ideal solution. Voluntary benefits allow employers to offer benefits that are attractive to employees without added cost to the company. Employees benefit because they have a variety of insurance options available conveniently in one place, and often with lower premiums than individual policies they would have bought themselves. - View the PDF
In December 2007, the U.S. Equal Employment Opportunity Commission (EEOC) issued final regulations under the Age Discrimination in Employment Act (ADEA) on coordinating retiree health benefits with Medicare eligibility. The final regulations allow employers to alter, reduce or eliminate employer-sponsored retiree health benefits as retirees become eligible for Medicare or a state-sponsored retiree health benefits program without violating the ADEA. The final regulations became effective on Dec. 26, 2007.
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A medical child support order is a judgment, decree, or order (including an approval of a property settlement) that: Is made pursuant to State domestic relations law (including a community property law) or certain other State laws relating to medical child support (see Q1-8); and Provides for child (more)