For purposes of individual eligibility for tax subsidies through a public Exchange and for compliance with the employer shared responsibility rules under §4980H, it is important to understand whether coverage offered under an employer-sponsored group health plan is “affordable.”

Applicable large employers (ALEs) are subject to §4980H offer of coverage requirements and §6056 employer reporting requirements on Form 1094-C and Form 1095-Cs. ALEs who fail to comply with §4980H offer of coverage requirements may face penalties (i.e., employer shared …

With the number of individuals enrolled in high-deductible health plans (HDHPs) growing, and health care costs continuing to rise, health savings accounts (HSAs) provide an option for reimbursement of medical expenses on a tax-favored basis without some of the financial …

The Employer Focus Newsletter provides a quarterly recap of many of the key benefits and compliance headlines from the previous quarter.

The IRS has begun issuing Letter 5699 (for failure to report) and Letter 226J assessments (with proposed §4980H penalties) for the 2024 tax year.

Any time an employee requests to add coverage for themselves or a family member mid-plan year (outside open enrollment), we first look to HIPAA special enrollment rules. If a HIPAA special enrollment event is triggered, a group health plan is …

If the leave of absence is unpaid or not being paid through payroll (e.g. STD or worker’s compensation), it is advisable to have a process for obtaining the employee contribution and to communicate that process accordingly.

Many employers provide incentives to employees (and sometimes their family members) for not smoking or using tobacco or nicotine products to encourage them to adopt healthier lifestyles and to potentially cut down on medical costs.

On May 18, the White House released a Fact Sheet that announces an expansion of TrumpRx.gov to include more than 600 generic medications, allowing Americans to compare discounted cash prices for common drugs across pharmacies and delivery providers such as …

Health and welfare benefits are just one of many important matters that employers must consider when participating in a merger or acquisition. Due diligence efforts prior to a merger or acquisition often focus on benefits with significant financial assets (e.g., …

The Form 5500 Series is part of ERISA’s reporting and disclosure framework and serves as a key compliance tool for the Department of Labor (DOL), plan participants, and other government agencies.

Employers may be required by applicable state or federal statutes and regulations to provide coverage to members of their employees’ families in addition to their employees.