A recent Sixth Circuit Court of Appeals case considered a situation that we have seen in our practice: An employee gets sick, goes out on FMLA leave, and then is placed on short term disability. The employer’s health plan provides that employees are eligible for the plan if they are regularly scheduled to work at
Understanding Employee Benefits and key developments in the employee benefits field and items of interest to our clients. MORE
Health Plan
Just Because You Have Insurance Doesn’t Mean That You Have Coverage
By Stinson LLP on
A recent federal court decision from the Eastern District of Wisconsin dealt with a situation of an employer who failed to provide a former employee proper COBRA notices and failed to accept a premium payment for the COBRA coverage. The employer had sent the required COBRA notice when the employee terminated employment but had not …
IRS Clarifies Medicare Premium Deductions for Sole Proprietors, Partners and S Corporation Shareholder-Employees
By Stinson LLP on
Sole proprietors, partners (including LLC members) and two percent shareholders in an S corporation are not treated as “employees” for purposes of certain benefits. Among those benefits is employer provided health insurance coverage. While employer subsidies for health coverage are generally excluded from the income of employees, that is not the case for sole proprietors, …
Self-Compliance Tool for HIPAA and Other Health Care Related Provisions
By Stinson LLP on
The Department of Labor recently updated its self-compliance tool for plan sponsors and plan administrators of group health plans. The self-compliance tool contains questions relating to requirements on issues such as limitations on preexisting conditions, certificates of creditable coverage, special enrollment rights, HIPAA nondiscrimination rules, wellness programs, Mental Health Parity and Addiction Equity Act, Newborns’ …
FAQs Issued on Mental Health Parity and Addiction Equity Act of 2008
By Stinson LLP on
The Departments of Labor, Treasury and Health and Human Services have the responsibility to administer and enforce the Mental Health Parity and Addiction Equity Act of 2008. The Departments recently issued two sets of FAQs, describing the guidance issued under the Act and restating some of that guidance in an accessible Q & A format.…
FAQs Issued on the Summary of Benefits in Coverage
By Stinson LLP on
The Departments of Labor, Health and Human Services, and Treasury have jointly issued another set of FAQs on the Patient Protection and Affordable Care Act (PPACA), the health care reform law. These are part nine of FAQs issued on different PPACA topics. This particular set discusses the Summary of Benefits and Coverage or SBC, about …
Texting Can Cause HIPAA Violations
By Stinson LLP on
The Office for Civil Rights, which is the arm of the Department of Health and Human Services that enforces HIPAA privacy and security rules, recently announced the settlement of an enforcement action against a small cardiothoracic surgery practice. The practice reportedly posted protected health information (PHI) on an internet-based publically accessible calendar and transmitted PHI …
Bad Things Can Happen to Employers Who Do Not Follow the Terms of Their Group Health Insurance Policies
By Stinson LLP on
Blue Cross of Northeastern Pennsylvania (“Blue Cross”) insured New Life Homecare, Inc. (“New Life”) under a group health insurance contract. The insurance contract required New Life to enroll at least 75% of its eligible participants in the plan and provided that no more than 15% of the eligible employees could reside more than 20 miles …
HSA/HDHP Limits for 2013
By Stinson LLP on
The IRS has released the 2013 limits for Health Savings Account (HSA) contributions. The annual contribution limit for 2013 increases to $3,250 for an individual with self only coverage and $6,450 for an individual with family coverage from $3,100 and $6,250, respectively for 2012. The minimum annual deductible for a qualifying high deductible health plan…
How to Pay the Patient-Centered Outcomes Research Trust Fund Fee
By Stinson LLP on
In previous blogs here, here and here, I discussed generally the recently published proposed regulations on which taxpayers may rely regarding the new fee imposed under the Patient Protection and Affordable Care Act (PPACA) to fund the Patient-Centered Outcomes Research Trust Fund. The fee is considered an excise tax but is not reported …