Volume 5, Number 8

Reminder: Medicare Part D Notice Due October 15

SHRM

Employers whose health care plans include prescription drug benefits must notify Medicare-eligible employees by October 15 of each year whether their drug benefit is creditable coverage, meaning that it is expected to cover, on average, as much as the standard Medicare Part D prescription drug plan.

The creditable-coverage notice must be given to all Part D-eligible individuals who are covered under, or apply for, an employer's prescription drug benefits plan. This requirement applies to Medicare beneficiaries who are active employees and those who are retired, as well as Medicare beneficiaries who are covered as spouses under active or retiree coverage. The full article is available here.

One Less Thing to Do: HIPAA Certificates of Creditable Coverage

International Foundation of Employee Benefit Plans

Starting January 1, 2015, HIPAA certificates of creditable coverage will no longer be required.

The health plans used to have to provide these certificates to individuals losing health coverage, but now with the ACA prohibiting preexisting exclusion periods for all health plans, no certificates of creditable coverage need to be issued on or after December 31, 2014. Read the full article here.

Tobacco Cessation Treatment and the ACA's Preventive Care Mandate

Lockton Health Reform and Compliance

The Affordable Care Act (ACA) requires non-grandfathered health care plans to cover a wide variety of preventive care benefits at no out-of-pocket cost.

Read the full article addressing tobacco cessation treatment and FAQs regarding its involvement in the ACA's preventive care mandate here.

Implementing Health Care Reform: Tax Form Instructions

Health Affairs Blog

On August 28, 2014, the Internal Revenue Service re-released the draft forms that will be used by employers, insurers, and exchanges for reporting Affordable Care Act tax information to individuals and to the IRS for 2014 and 2015, as well as the instructions for completing those forms.

The IRS also released in the Federal Register requests for public comments on three of those forms - the 1094-B, the 1094-C, and the 1095-C - under the Paperwork Reduction Act. There is a wide variety of instructions for each of these forms. Instructions and guidance released by the Centers for Medicare and Medicaid Services can be found here.

EEOC Sick Over Wellness Programs

Mazursky Constantine LLC

Even if a wellness program complies with HIPAA and the applicable limits on the amount of rewards, it must also comply with the Americans with Disabilities (ADA), which generally limits an employer's ability to conduct medical examinations and disability-related inquiries unless participation is "voluntary."

Recently, the Equal Employment Opportunity Commission (EEOC) filed a lawsuit against an employer under the ADA, related to its maintenance of a wellness program. Although far from a death knell for wellness programs, employers should nevertheless take note of the EEOC's attempted enforcement in this case when considering program design. Read the full article here.

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