United Benefit Advisors Insight and Analysis Blog

Danielle Capilla

Chief Compliance Officer at United Benefit Advisors

Recent Posts

ERISA's "Church Plan" Exception

Posted by: Danielle Capilla    Aug 3, 2017 9:30:00 AM

The Employee Retirement Income Security Act (ERISA) was signed in 1974. The U.S. Department of Labor (DOL) is the agency responsible for administering and enforcing this law. For many years, most of ERISA's requirements applied to pension plans. However, in recent years that has changed, and group plans (called "welfare benefit plans" by ERISA and the DOL) now must meet a number of requirements. Government and church plans do not need to comply with ERISA.

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Topics: ERISA, group benefit plans, church plan

Determining COBRA Premiums for Fully Insured and Self-Funded Health Plans

Posted by: Danielle Capilla    Aug 1, 2017 1:04:34 PM

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows qualified beneficiaries who lose health benefits due to a qualifying event to continue group health benefits. While some group health plans may provide COBRA continuation coverage at a reduced rate or at no cost, most qualified beneficiaries must pay the full COBRA premium. The COBRA election notice should include information about COBRA premiums.

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Topics: health insurance premiums, COBRA, fully insured health plans, COBRA continuation coverage

Best Practices for Initial COBRA Notices

Posted by: Danielle Capilla    Jul 25, 2017 9:30:00 AM

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires group health plans to provide notices to covered employees and their families explaining their COBRA rights when certain events occur. The initial notice, also referred to as the general notice, communicates general COBRA rights and obligations to each covered employee (and his or her spouse) who becomes covered under the group health plan. This notice is issued by the plan administrator within the first 90 days when coverage begins under the group health plan and informs the covered employee (and his or her spouse) of the responsibility to notify the employer within 60 days if certain qualifying events occur in the future.

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Topics: group health insurance, COBRA continuation coverage, notice of coverage

Small Employers Ask about Form 5500

Posted by: Danielle Capilla    Jul 18, 2017 9:30:00 AM

UBA’s compliance team leverages the collective expertise of its independent partner firms to advise 36,000 employers and their 5 million employees. Lately, a common question from employers is: If a health and welfare benefit plan has fewer than 100 participants, then does it need to file a Form 5500?

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Topics: Small Employers, Form 5500, Group health plans

Extension of Maximum COBRA Coverage Period

Posted by: Danielle Capilla    Jul 13, 2017 9:30:00 AM

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee’s own cost. The length of the COBRA coverage period depends on the qualifying event and is usually 18 or 36 months. However, the COBRA coverage period may be extended under the following five circumstances:

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Topics: COBRA, COBRA continuation coverage, qualifying event, coverage period

DOL Asks for MHPAEA Related Comments; Clarifies Eating Disorder Benefit Requirements

Posted by: Danielle Capilla    Jun 28, 2017 9:30:00 AM

Earlier this month, the Department of Labor (DOL) provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and the 21st Century Cures Act (Cures Act). This is the DOL's 38th FAQ on implementing the Patient Protection and Affordable Care Act (ACA) provisions and related regulations. The DOL is requesting comments on a draft model form for participants to use to request information regarding nonquantitative treatment limitations, and confirms that benefits for eating disorders must comply with the MHPAEA. Comments are due by September 13, 2017.

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Topics: ACA, Affordable Care Act, Mental Health Parity and Addiction Act, mental health, 21st Century Cures Act

What Employers Need to Know about the Senate Proposed Healthcare Bill

Posted by: Danielle Capilla    Jun 26, 2017 9:30:00 AM

On June 22, 2017, the United States Senate released a "Discussion Draft" of the "Better Care Reconciliation Act of 2017" (BCRA), which would substitute the House's House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The House bill was titled the "American Health Care Act of 2017" (AHCA). Employers with group health plans should continue to monitor the progress in Washington, D.C., and should not stop adhering to any provisions of the ACA in the interim, or begin planning to comply with provisions in either the BCRA or the AHCA.

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Topics: ACA, health care reform, Better Care Reconciliation Act of 2017, American Health Care Act of 2017

What Qualifying Events Trigger COBRA?

Posted by: Danielle Capilla    Jun 20, 2017 11:25:55 AM

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee’s own cost. Per regulation, qualifying events are specific events that cause or trigger an individual to lose health coverage. The type of qualifying event determines who the qualified beneficiaries are and the maximum length of time a plan must offer continuation coverage. A group health plan may provide longer periods of continuation coverage beyond the maximum 18 or 36 months required by law.

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Topics: change in status event, COBRA continuation coverage, health care coverage

What Happens to Coverage When Employees Reduce Their Hours?

Posted by: Danielle Capilla    Jun 13, 2017 9:30:00 AM

The Section 125 cafeteria plan regulations and the Patient Protection and Affordable Care Act (ACA) require employers to take certain actions when an employee reduces hours.

Consider this scenario: An employer has an employee who is reducing hours below 30 hours per week. The employee is performing the same job and duties. The employee was determined to be full-time during the most recent measurement period. The employee is currently in a stability period.

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Topics: ACA, cafeteria plan, Affordable Care Act, Section 125 plan, reduction in hours

2018 Amounts for HSAs; Retroactive Medicare Coverage Effect on Contributions

Posted by: Danielle Capilla    Jun 8, 2017 9:30:00 AM

IRS Releases 2018 Amounts for HSAs

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Topics: HDHPs, health savings accounts, UBA Health Plan Survey, HSAs, Medicare coverage